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