-----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, FVlH4D0XVO5+wfjb1Jesv9MEe7Rqaigx8d4zt2SUuvCb7O6kCMoDY5zH4FRq9QIu oagtNCE0iM1wIitO4N5aMQ== /in/edgar/work/0000950123-00-009473/0000950123-00-009473.txt : 20001019 0000950123-00-009473.hdr.sgml : 20001019 ACCESSION NUMBER: 0000950123-00-009473 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000930 FILED AS OF DATE: 20001018 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: EBIX COM INC CENTRAL INDEX KEY: 0000814549 STANDARD INDUSTRIAL CLASSIFICATION: [7373 ] IRS NUMBER: 770021975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-15946 FILM NUMBER: 741841 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: RENNES FOUNDATION CENTRAL INDEX KEY: 0001094515 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OWNER FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: AEWLESTRUSSE 38 STREET 2: VODUZ LIECHTREUSTEIN FL MAIL ADDRESS: STREET 1: S.W. PORTE 3 POST OFFICE BOX 3580 STREET 2: ZURICH SWITERLAND 4 1 y41478e4.txt FORM 4 1 U.S.SECURITIES AND EXCHANGE COMMISSION WASHINGTON D.C., 20549 FORM 4 OMB APPROVAL ------------------------- [ ] CHECK THIS BOX IF NO LONGER STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB Number: 3235-0287 SUBJECT TO SECTION 16. FORM Expires: December 31, 2001 4 OR FORM 5 OBLIGATIONS MAY Estimated average burden CONTINUE. SEE INSTRUCTION 1(b). hours per response.....0.5 Filed pursuant to Section 16(a) of the Securities and 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. Issuer Name and Ticker or Trading Symbol | 6. Relationship of Reporting Person(s) Rennes Foundation | ebix.com, Inc. (EBIX) | to Issuer (Check all applicable) | | _____ Director __X__ 10% Owner - -------------------------------------------------------------------------------------------| _____ Officer (give title below) (Last) (First) (Middle) | 3. IRS Identification | 4. Statement for | _____ Other (specify below) | Number of Reporting | Month/Year | Aeulestrasse 38 | Person, if any | September, 2000 | - ----------------------------------------| entity (Voluntary) |-------------------------|---------------------------------------- (Street) | | 5. If Amendment, | 7. Individual or Joint/Group Filing FL-9490 Vaduz | | Date of Original | (Check Applicable Line) Principality of Liechtenstein | | (Month/Year) | _X_ Form filed by One Reporting Person | | | ___ Form filed by More than One | | | Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) | TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security |2.Transaction | 3.Transaction | 4.Securities Acquired (A)| 5.Amount of | 6.Owner-| 7.Nature (Instr. 3) | Date | Code | or Disposed of (D) | Securities | ship | of | | (Instr. 8) | (Instr. 3,4, and 5) | Beneficially| Form: | Indirect |(Month/Day/ | | | Owned at End| Direct | Bene- | Year) | |--------------------------| of Month | (D) or | ficial | | | Amount | (A) | Price | | Indirect| Owner- | | | | or | | (Instr. 3, | (I) | ship | | | | (D) | | and 4) |(Instr.4)|(Instr.4) - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- Common Stock |9/1/99- | | | | 6.79- | | | | 5/18/00 | P |1,318,510| A | 14.05 | 2,331,000 | D | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- Common Stock |6/8/00- | | | | 2.46- | | | | 09/01/00 | S | 83,000 | D | 6.0 | 2,248,000 | D | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- | | | | | | | | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- | | | | | | | | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- | | | | | | | | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- | | | | | | | | - ----------------------------------------|--------------|---------------|---------------|----------|-------------|---------|--------- | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------
1 2 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.Conversion | 3.Transaction | 4.Transaction | 5.Number of | 6.Date Exer- | 7.Title and Amount (Instr. 3) | or Exercise | Date | Code | Derivative | cisable and | of Underlying | Price of | | (Instr. 8) | Securities | Expiration Date | Securities | Derivative | (Month/Day/ | | Acquired (A) | (Month/Day/Year) | (Instr. 3 and 4) | Security | Year) | | or Disposed | | | | | | of (D) |-------------------------------------- | | | | (Instr. 3, | Date | Expir- | | Amount or | | | | 4, and 5) | Exer- | ation | Title | Number of | | |---------------|--------------| cisable | Date | | Shares | | | Code | V | (A) | (D) | | | | - ------------------------------------------------------------------------------------------------------------------------------------ | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - -------------------------------|--------------|---------------|-------|-------|------|-------|---------|--------|--------|---------- | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ 8.Price of | 9.Number of | 10.Ownership | 11.Nature of | Derivative | Derivative | Form of | Indirect | Security | Securities | Derivative | Beneficial | (Instr. 5) | Beneficially | Security; | Ownership | | Owned at End | Direct (D) or | (Instr. 4) | | of Month | Indirect (I) | | | (Instr. 4) | (Instr. 4) | | - -------------------------------------------------------------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - --------------|----------------|-------------------|---------------| | | | | - ------------------------------------------------------------------- Explanation of Responses: /s/ Juerg Keller October, 13 2000 ------------------------------------ ----------------- **Signature of Reporting Person Date Name: Juerg Keller Title: Director ** 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.
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