-----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, Kv815rBAa7NXpisZpKUextK6vV2ehCssmR/i6r4aU/UnoypmLq9c+rU7rrR5k1tc P5gRCHzyGjZlWpSJUQ89PA== 0001209191-08-009733.txt : 20080213 0001209191-08-009733.hdr.sgml : 20080213 20080213134225 ACCESSION NUMBER: 0001209191-08-009733 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20071231 FILED AS OF DATE: 20080213 DATE AS OF CHANGE: 20080213 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: 0228 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: HOWELL HILTON H JR CENTRAL INDEX KEY: 0001213166 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03722 FILM NUMBER: 08603258 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD, N.E. CITY: ATLANTA STATE: GA ZIP: 30319 5 1 doc5.xml FORM 5 SUBMISSION X0202 5 2007-12-31 0 0 0 0000008177 ATLANTIC AMERICAN CORP AAME 0001213166 HOWELL HILTON H JR 4370 PEACHTREE ROAD, N.E. ATLANTA GA 30319 1 1 0 0 President & CEO Common Stock 202346 D Common Stock 87259 I 401(k) Plan Common Stock 39025 I By Spouse Common Stock 2175 I By Spouse IRA Common Stock 6720 I Joint - Harriett J. Robinson w/son Option to Buy Cmn Stk 200000 200000 D Mr. Howell also has an indirect ownership interest in 87259 shares held in a 401(k) Plan based on the most recent plan statement. Mr. Howell also has an indirect ownership interest in 39025 shares for which 1025 shares are held directly by spouse; 6000 shares held F/B/O daughter, Alston Elizabeth Howell, with spouse as Custodian; 7000 shares held F/B/O, son, Hilton Hatchett Howell, III, with spouse as Custodian; 12500 shares held F/B/O daughter, Anna Louise Howell, with spouse as Custodian; and 12500 shares held F/B/O daughter, Julia Bailey Howell, with spouse as Custodian, all for which Mr. Howell expressly disclaims beneficial ownership of such securities. Mr. Howell also has an indirect ownership interest in 2175 shares held directly by Mr. Howell's spouse in an IRA account for which Mr. Howell expressly disclaims beneficial ownership of such securities. Mr. Howell also has an indirect ownership interest in 6720 shares owned jointly by his son with Harriett J. Robinson for which Mr. Howell expressly disclaims beneficial ownership in such securities. Mr. Howell also holds employee stock options to acquire 100000 shares of common stock granted under the Company's 1992 Incentive Plan at an exercise price of $1.25 and 100000 shares of common stock under the Company's 2002 Incentive Plan at an exercise price of $1.59. Janie L. Ryan POA 2008-02-13 -----END PRIVACY-ENHANCED MESSAGE-----