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