0001140361-13-007363.txt : 20130214 0001140361-13-007363.hdr.sgml : 20130214 20130214162003 ACCESSION NUMBER: 0001140361-13-007363 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: BRUNSON WILLIAM L JR CENTRAL INDEX KEY: 0001239470 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18649 FILM NUMBER: 13614199 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 0001239470 BRUNSON WILLIAM L JR 661 EAST DAVIS ELBA AL 36323 0 1 0 0 President/CEO Common Stock 1999-07-29 4 J 0 L 220 A 6519 D Common Stock 2013-02-14 4 J 0 L 5950 D 67540 I By Jerry B. Brunson Marital Trust/Jerry B. Brunson Family Trust Common Stock 1000 I By children in household Common Stock 4087 I By 401-K Plan Common Stock 366445 I By Brunson Properties, a general partnership In a review of beneficial ownership reported, the Reporting Person discovered that prior filings had understated the aggregate holdings by 220 shares. Records of the Reporting Person have been reviewed in an attempt to determine the source(s) of the discrepancy. The exact transaction(s) resulting in the source of the 220 share discrepancy has not been identified. However, the current discrepancy begins with transaction reported on this Form 5. Amount of securities beneficially owned on the Form 5 accurately reflect current holdings. The Reporting Person was made aware of dispositions of stock held in the Jerry B. Brunson Marital and Jerry B. Brunson Family Trusts. The Reporting Person disclaims beneficial ownership associated with these shares. The shares reported on this Form 5 accurately reflect the current number of shares held in the Trusts as of 2/14/2013. Brian R. McLeod, Attorney-in-fact 2013-02-14