0001140361-18-000875.txt : 20180104 0001140361-18-000875.hdr.sgml : 20180104 20180104174144 ACCESSION NUMBER: 0001140361-18-000875 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20180102 FILED AS OF DATE: 20180104 DATE AS OF CHANGE: 20180104 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: 18511302 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 2018-01-02 0 0000865058 NATIONAL SECURITY GROUP INC NSEC 0001239490 CLARK FRED JR 2100 FLOWERS ROAD MATHEWS AL 36052 1 0 0 0 Common Stock 2018-01-02 5 G 0 15581 A 73932 D Common Stock 2018-01-02 5 G 0 933 A 12685 I By Minor Children Common Stock 2018-01-02 5 G 0 933 A 13618 I By Minor Children Shares were obtained via bona fide gift on January 2, 2018. Brian R. McLeod, Attorney-in-fact 2018-01-04