3 1 a2047963z3.txt FORM 3 ------------ ----------------------------------- FORM 3 OMB APPROVAL ------------ ----------------------------------- OMB Number: 3235-0104 Expires: October 31, 2001 Estimated average burden hours per response............0.5 ----------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol Requiring Statement (Month/Day/Year) BRiT Insurance Holdings Plc April 27, 2001 ebix.com, Inc. ("EBIX") ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. I.R.S. Identification 5. Relationship of Reporting 6. If Amendment, Date of Number of Reporting Person(s) to Issuer Original Person, (Check all applicable) (Month/Day/Year) if an entity (voluntary) / / Director /X/ 10% Owner ------------------------ N/A (non-U.S. Company) / / Officer (give / / Other (specify 7. Individual or Joint/ 55 Bishopsgate title below) below) Group Filing ------------------------------------------ (Check Applicable Line) (Street) ------------------------ /X/ Form filed by One Reporting Person / / Form filed by More than One Reporting London EC2N 3AS United Kingdom Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE 1 NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial Ownership (Instr. 4) Beneficially Owned Direct (D) or (Instr. 5) (Instr. 4) Indirect (I) (Instr. 5) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.10 par value 2,248,300 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. *If the form is filed by more than one reporting person, SEE Instruction POTENTIAL PERSONS WHO ARE TO RESPOND TO THE 5(b)(v). COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. (Over) SEC 1473 (7-97) ------------------------------------------------------------------------------------------------------------------------------------
FORM 3 (CONTINUED) TABLE II DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Date Exercisable 3. Title and Amount 4. Conversion 5. Ownership 6. Nature of (Instr. 4) and Expiration Date of Securities or Exercise Form of Indirect (Month/Day/Year) Underlying Price of Derivative Beneficial Derivative Security Derivative Security: Ownership (Instr. 4) Security Direct (D) (Instr. 5) ------------------------------------------------ or Indirect Date Expiration Amount or (I) Exercisable Date Title Number (Instr. 5) of Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: May 7, 2001 ------------------------------------- --------------------------- **Signature of Reporting Person Date /s/ Neil Eckert, Director /s/ Matthew Scales, Director *If the form is filed by more than one reporting person, SEE Instruction 5(b)(v). ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, SEE Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2 SEC 1473 (7-97)