0001140361-13-002875.txt : 20130123 0001140361-13-002875.hdr.sgml : 20130123 20130123170908 ACCESSION NUMBER: 0001140361-13-002875 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130118 FILED AS OF DATE: 20130123 DATE AS OF CHANGE: 20130123 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLARK FRED JR CENTRAL INDEX KEY: 0001239490 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18649 FILM NUMBER: 13543369 MAIL ADDRESS: STREET 1: 661 EAST DAVIS CITY: ELBA STATE: AL ZIP: 36323 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL SECURITY GROUP INC CENTRAL INDEX KEY: 0000865058 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 631020300 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 661 E DAVIS ST CITY: ELBA STATE: AL ZIP: 36323 BUSINESS PHONE: 2058972273 4 1 doc1.xml FORM 4 X0306 4 2013-01-18 0 0000865058 NATIONAL SECURITY GROUP INC NSEC 0001239490 CLARK FRED JR 2100 FLOWERS ROAD MATHEWS AL 36052 1 0 0 0 Common Stock 2013-01-18 2013-01-18 4 A 0 1000 A 2200 D The reporting person received these shares of common stock pursuant to The National Security Group, Inc. 2009 Equity Incentive Plan in lieu of payment to the reporting person of $8,200 payable for director fees for the year ended December 31, 2012. Brian R. McLeod, Attorney-in-fact 2013-01-23