0001140361-17-001573.txt : 20170111 0001140361-17-001573.hdr.sgml : 20170111 20170111165947 ACCESSION NUMBER: 0001140361-17-001573 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20170109 FILED AS OF DATE: 20170111 DATE AS OF CHANGE: 20170111 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 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: 17523384 MAIL ADDRESS: STREET 1: 661 EAST DAVIS CITY: ELBA STATE: AL ZIP: 36323 4 1 doc1.xml FORM 4 X0306 4 2017-01-09 0 0000865058 NATIONAL SECURITY GROUP INC NSEC 0001239490 CLARK FRED JR 2100 FLOWERS ROAD MATHEWS AL 36052 1 0 0 0 Common Stock 2017-01-09 4 G 0 10800 15.97 D 49077 I By Clark's Investment Group, Ltd. Common Stock 2017-01-09 4 G 0 3210 15.97 A 28594 D Common Stock 2017-01-09 4 G 0 1752 15.97 A 11752 I By Minor Children Shares were distributed via bona fide gift. Shares were received via bona fide gift. Brian R. McLeod, Attorney-in-fact 2017-01-11