-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GmN4ldf+PwCtNMWUrhxm2EdX8xWPHPuWPdw9u7LiZCFPiX+n5Uc6dieecx5z63Hk dtePWdsOhicyv22mJ7IjEQ== 0000912057-02-030975.txt : 20020812 0000912057-02-030975.hdr.sgml : 20020812 20020812090456 ACCESSION NUMBER: 0000912057-02-030975 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020812 FILED AS OF DATE: 20020812 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: EBIX COM INC CENTRAL INDEX KEY: 0000814549 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 770021975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-15946 FILM NUMBER: 02725803 BUSINESS ADDRESS: STREET 1: 3501 ALGONQUIN RD STREET 2: STE 500 CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 BUSINESS PHONE: 8475063100 MAIL ADDRESS: STREET 1: 3501 ALGONQUIN ROAD CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 FORMER COMPANY: FORMER CONFORMED NAME: DELPHI INFORMATION SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19920703 COMPANY DATA: COMPANY CONFORMED NAME: BRIT INSURANCE HOLDINGS PLC CENTRAL INDEX KEY: 0001140037 OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 55 BISHOPSGATE STREET 2: LONDON ENGLAND UK CITY: EC2N 3A5 MAIL ADDRESS: STREET 1: 55 BISHOPSGATE STREET 2: LONDON ENGLAND UK CITY: EC2N 3A5 4 1 a2086646z4.txt FORM 4
- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ----------------------------- / / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287 LONGER SUBJECT TO EXPIRES: PENDING SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5 CONTINUE. SEE Section 30(h) of the Investment Company Act of 1940 ----------------------------- INSTRUCTION 1(b). (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director X 10% Owner Brit Insurance Holdings Plc ebix.com, Inc. ("EBIX") ---- ---- - --------------------------------------------------------------------------------------------- Officer (give Other (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for ---- title ---- (specify Number of Reporting Month/Year below) below Person, if an entity ----------------- ------------------ 55 Bishopsgate (voluntary) August 2002 - -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original _X_Form filed by One Reporting Person (Month/Year) ___Form filed by More than One London EC2N 3AS UK April 2001 Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 8) Owned at Direct Bene- (Month/ End of (D) or ficial Day/ ------------------------------------------- Month Indirect Owner- Year) (A) or (I) ship Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.10 par value 08/07/2002 P 20,000 A 0.64 7,163,850 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, $.10 par value 08/09/2002 P 7,700 A 0.606 7,171,550 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (7-97) 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 CONTROL NUMBER.
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- (Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex- Exercise Date (Instr. 8) quired (A) or Dis- piration Date Price of (Month/ posed of (D) (Month/Day/ Deriv- Day/ (Instr. 3, 4, and 5) Year) ative Year) Security -------------------- Date Expira- -------------------------------------- Exer- tion cisable Date Code V (A) (D) - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ 7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature lying Securities of of Deriv- ship of In- (Instr. 3 and 4) Deriv- ative Form direct ative Securi- of De- Bene- Secur- ties rivative ficial ity Bene- Secu- Own- (Instr. ficially rity: ership 5) Owned Direct (Instr. 4) at End (D) or Amount or of Indi- Title Number of Month rect (I) Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ Explanation of Responses: /s/ Dane Douetil /s/ Andrew Holland 9 August 2002 ------------------------------------ ------------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date 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 1474 (7-97)
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