-----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, I/6QM9cgks3aGVXViNHNpKQp9XoaC0KlkoSVJKvgqOIWUR+cwMszI1Fu7KDaDuNn iR7JIOi9r+PWEboLH4zWjQ== 0001209191-06-027170.txt : 20060503 0001209191-06-027170.hdr.sgml : 20060503 20060503113337 ACCESSION NUMBER: 0001209191-06-027170 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20060502 FILED AS OF DATE: 20060503 DATE AS OF CHANGE: 20060503 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROBINSON HARRIETT J CENTRAL INDEX KEY: 0001196567 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03722 FILM NUMBER: 06802275 BUSINESS ADDRESS: STREET 1: 3500 TUXEDO ROAD NW CITY: ATLANTA STATE: GA ZIP: 30305 BUSINESS PHONE: 4042665532 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATLANTIC AMERICAN CORP CENTRAL INDEX KEY: 0000008177 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 581027114 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4370 PEACHTREE RD NE CITY: ATLANTA STATE: GA ZIP: 30319 BUSINESS PHONE: 4042665500 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD CITY: ATLANTA STATE: GA ZIP: 30319 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2006-05-02 0 0000008177 ATLANTIC AMERICAN CORP AAME 0001196567 ROBINSON HARRIETT J 4370 PEACHTREE ROAD, N.E. ATLANTA GA 30319-3054 1 0 1 1 Trustee under Rule 16a-8 Common Stock 2006-05-02 4 A 0 1993 A 586396 D Common Stock 6720 D Common Stock 15540 I 401(k) Plan by Spouse Common Stock 3490144 I By Gulf Capital Services Common Stock 3953256 I Trustee as C/F Daughter Common Stock 4026992 I Trustee as C/F Daughter Common Stock 2006-05-02 4 A 0 1993 A 2093315 I By Spouse Option to Buy Cmn Stk 2000 D Represents 1993 shares of restricted stock that were awarded pursuant to the Company's 2002 Incentive Plan. No consideration is required to be paid by the recipient. Mrs. Robinson also has a direct ownership of 6720 shares owned jointly with her grandson. Mr. Robinson also has an indirect ownership interest in 15540 shares held in a 401(k) Plan based on the most recent plan statement. Mrs. Robinson also has an indirect ownership interest in 3490144 shares owned by Gulf Capital Services for which her spouse individually holds a 24% interest in the Partnership, with the remaining partnerships held in equal shares by Trust for the benefit of the reporting person's daughters, with the reporting person as Trustee. Mrs. Robinson also has an indirect ownership interest in 3953256 shares held by self as Trustee for daughter, Robin Robinson, securities held directly by Trust, for which Mrs. Robinson expressly disclaims beneficial ownership of such securities. Mrs. Robinson also has an indirect ownership interest in 4026992 shares held by self as Trustee for daughter, Jill Robinson, securities held directly by Trust, for which Mrs. Robinson expressly disclaims beneficial ownership of such securities. Mrs. Robinson also has an indirect ownership interest in 2091322 shares, of which 846613 shares are held by spouse; 946702 shares held by Delta Life Ins. Co.; and, 300000 shares are held by Delta Fire & Casualty Ins. Co., all of which Mrs. Robinson expressly disclaims any beneficial ownership of such securities. Mrs. Robinson also has a direct ownership interest in options to acquire 2000 shares of common stock granted under the Company's 1996 Non-Employee Director Stock Option Plan at exercise prices ranging from $1.90 to $2.68. Janie L. Ryan, POA 2006-05-02 -----END PRIVACY-ENHANCED MESSAGE-----