0001140361-13-007317.txt : 20130214
0001140361-13-007317.hdr.sgml : 20130214
20130214160748
ACCESSION NUMBER: 0001140361-13-007317
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20121231
FILED AS OF DATE: 20130214
DATE AS OF CHANGE: 20130214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: CLARK FRED JR
CENTRAL INDEX KEY: 0001239490
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-18649
FILM NUMBER: 13613677
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
5
1
doc1.xml
FORM 5
X0306
5
2012-12-31
0
0
1
0000865058
NATIONAL SECURITY GROUP INC
NSEC
0001239490
CLARK FRED JR
2100 FLOWERS ROAD
MATHEWS
AL
36052
1
0
0
0
Phantom Stock Units
9.10
2012-02-29
5
J
0
4
9.10
A
Phantom Stock Units
4
365
D
Phantom Stock Units
9.10
2012-02-29
4
J
0
L
365
9.10
D
Phantom Stock Units
365
0
D
The phantom stock units were awarded under the nonqualified deferred compensation plan in which directors could elect to defer their directors' fees by receiving phantom stock units payable in cash upon separation from service from the board. These shares were acquired during the fiscal year pursuant to the dividend reinvestment component of the nonqualified deferred compensation plan which was frozen 12/31/2004.
The phantom stock units were awarded under the nonqualified deferred compensation plan in which directors could elect to defer their directors' fees by receiving phantom stock units payable in cash upon separation from service from the board. The plan was frozen on 12/31/2004. These shares were disposed of and distributed in cash.
Upon separation from service from the Board, phantom stock units will be settled in cash at the then current market price of common stock.
Pertains to phantom stock plan in which election to defer fees is not a reportable event under Section 16, however acquisitions of phantom stock pursuant to the election are reportable. These deferrals are exempt transactions for purposes of Section 16b-3(d). On December 19, 2012, the total remaining balance of each participants shares, which became payable February 29, 2012, were distributed in cash.
Brian R. McLeod, Attorney-in-fact
2013-02-14