-----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, Pk4AtozmL5a6iK/G1fSRSt765eDM6lUK9EMU4Ir+1Ij6UCkqX7fP2vO9OBX7HC7R B9q5Rr+irgUbwXzByy/Z8A== 0001209191-07-005397.txt : 20070126 0001209191-07-005397.hdr.sgml : 20070126 20070126130151 ACCESSION NUMBER: 0001209191-07-005397 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20070124 FILED AS OF DATE: 20070126 DATE AS OF CHANGE: 20070126 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 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: 07555512 BUSINESS ADDRESS: STREET 1: 3500 TUXEDO ROAD NW CITY: ATLANTA STATE: GA ZIP: 30305 BUSINESS PHONE: 4042665532 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2007-01-24 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 615711 D Common Stock 6720 D Common Stock 17686 I 401(k) Plan by Spouse Common Stock 2007-01-24 4 J 0 42863 2.96 A 3533007 I By Gulf Capital Services Common Stock 3953256 I Trustee as C/F Daughter Common Stock 4041792 I Trustee as C/F Daughter Common Stock 2124422 I By Spouse Option to Buy Cmn Stk 1000 D Mrs. Robinson also has a direct ownership of 6720 shares owned jointly with her grandson. Mrs. Robinson also has an indirect ownership interest in 17686 shares held by spouse in a 401(k) Plan based on the most recent plan statement, for which Mrs. Robinson expressly disclaims beneficial ownership of such securities. 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. On January 24, 2007, the Company declared a stock dividend payable to all holders of record of Series D Preferred Stock on January 24, 2007, of 0.61233 shares of common stock for each share of Series D Preferred Stock outstanding. 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 4041792 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 2124422 shares, of which 877720 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 1000 shares of common stock granted under the Company's 1996 Non-Employee Director Stock Option Plan at an exercise price of $2.68. Janie L. Ryan, POA 2007-01-26 -----END PRIVACY-ENHANCED MESSAGE-----