-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KNG2XKm1KKUMlmmZdUqY3pnCQSPMmjaaTDSObP4Kh9J243u3cV2QVGjb08NNiyFP rRtz6YoUszDb3eYmuHPcKg== 0000878897-04-000033.txt : 20040702 0000878897-04-000033.hdr.sgml : 20040702 20040702123012 ACCESSION NUMBER: 0000878897-04-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040630 FILED AS OF DATE: 20040702 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN MEDICAL SECURITY GROUP INC CENTRAL INDEX KEY: 0000878897 STANDARD INDUSTRIAL CLASSIFICATION: HOSPITAL & MEDICAL SERVICE PLANS [6324] IRS NUMBER: 391431799 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 BUSINESS PHONE: 9206611111 MAIL ADDRESS: STREET 1: 3100 AMS BLVD CITY: GREEN BAY STATE: WI ZIP: 54313 FORMER COMPANY: FORMER CONFORMED NAME: UNITED WISCONSIN SERVICES INC /WI DATE OF NAME CHANGE: 19930328 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BALLOU ROGER H CENTRAL INDEX KEY: 0001158369 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13154 FILM NUMBER: 04898404 BUSINESS ADDRESS: STREET 1: C/O CDI CORP STREET 2: 1717 ARCH ST. 35TH FL CITY: PHILADELPHIA STATE: PA ZIP: 19103 BUSINESS PHONE: 2155692200 MAIL ADDRESS: STREET 1: C/O CDI CORP STREET 2: 1717 ARCH ST 35TH FL CITY: PHILADELPHIA STATE: PA ZIP: 19103 4 1 primary_doc.xml PRIMARY DOCUMENT X0202 4 2004-06-30 0 0000878897 AMERICAN MEDICAL SECURITY GROUP INC AMZ 0001158369 BALLOU ROGER H 3100 AMS BOULEVARD GREEN BAY WI 54313 1 0 0 0 Common Stock 2004-06-30 4 A 0 162.84 27.25 A 7759.65 D /s/ Roger H. Ballou 2004-07-02 -----END PRIVACY-ENHANCED MESSAGE-----