0001140361-17-046215.txt : 20171214
0001140361-17-046215.hdr.sgml : 20171214
20171214153212
ACCESSION NUMBER: 0001140361-17-046215
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20171212
FILED AS OF DATE: 20171214
DATE AS OF CHANGE: 20171214
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: 171256070
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
2017-12-12
0
0000865058
NATIONAL SECURITY GROUP INC
NSEC
0001239490
CLARK FRED JR
2100 FLOWERS ROAD
MATHEWS
AL
36052
1
0
0
0
Common Stock
2017-12-12
4
P
0
5002
15.00
A
58221
D
Common Stock
2017-12-13
4
P
0
100
15.00
A
58321
D
Common Stock
2017-12-14
4
P
0
30
15.00
A
58351
D
Common Stock
11752
I
By Minor Children
Brian R. McLeod, Attorney-in-fact
2017-12-14