0001209191-11-054158.txt : 20111103 0001209191-11-054158.hdr.sgml : 20111103 20111103160131 ACCESSION NUMBER: 0001209191-11-054158 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20110906 FILED AS OF DATE: 20111103 DATE AS OF CHANGE: 20111103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: FOSS DONALD A CENTRAL INDEX KEY: 0000901185 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-20202 FILM NUMBER: 111177781 MAIL ADDRESS: STREET 1: 25505 WEST TWELVE MILE ROAD STREET 2: SUITE 3000 CITY: SOUTHFIELD STATE: MI ZIP: 48034-8339 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CREDIT ACCEPTANCE CORP CENTRAL INDEX KEY: 0000885550 STANDARD INDUSTRIAL CLASSIFICATION: PERSONAL CREDIT INSTITUTIONS [6141] IRS NUMBER: 381999511 STATE OF INCORPORATION: MI FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 25505 WEST TWELVE MILE ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034-8334 BUSINESS PHONE: 2483532700 MAIL ADDRESS: STREET 1: 25505 WEST TWELVE MILE ROAD CITY: SOUTHFIELD STATE: MI ZIP: 48034-8334 FORMER COMPANY: FORMER CONFORMED NAME: CREDIT ACCEPTANCE CORPORATION DATE OF NAME CHANGE: 19930328 4 1 doc4.xml FORM 4 SUBMISSION X0304 4 2011-09-06 0 0000885550 CREDIT ACCEPTANCE CORP CACC 0000901185 FOSS DONALD A 25505 WEST TWELVE MILE ROAD SOUTHFIELD MI 48034 1 1 1 0 Chairman Common Stock 2011-09-06 5 G 0 E 288027 0.00 A 3680735 D Common Stock 3290610 I By ex-wife's trust Common Stock 83166 I By limited liability company Common Stock 3657040 I By daughter's trusts On September 3, 2009, Mr. Foss transferred 2,000,000 shares of Credit Acceptance common stock to a grantor retained annuity trust for the benefit of himself and his minor child as remainderman. On September 6, 2011, 288,027 shares of Credit Acceptance common stock were transferred from such trust to Mr. Foss in satisfaction of such trust's 2011 annuity obligation. Mr. Foss' prior Form 4s for transactions relating to certain grantor retained annuity trusts created by Mr. Foss have reflected shares of Credit Acceptance common stock held by such trusts following such transactions as beneficially owned by Mr. Foss in Column 5 (with an annotations in Columns 6 and 7 reflecting "I" (for indirect ownership) and "by [son/daughter] through grantor retained annuity trust," respectively). Mr. Foss' direct and indirect ownership of Common Stock as reported in Column 5 of this Form 4 has been revised to reflect that Mr. Foss is not the indirect beneficial owner of the shares of Credit Acceptance common stock held by such grantor retained annuity trusts. Shares are owned of record by Karol A. Foss, as Trustee of the Karol A. Foss Revocable Trust Under Agreement dated January 16, 1981, as amended and restated on January 26, 1984, June 28, 1990, December 10, 1997 and April 1, 2005. Pursuant to an agreement dated December 6, 2001, Mr. Foss has sole voting power and dispositive power over such shares but Ms. Foss and her Trusts have the right to receive any dividends on and any proceeds from the sale of such shares. Shares are owned by a limited liability company in which Mr. Foss has a 20% interest. Shares are owned of record by Jill Foss Watson, as Trustee of the Jill Foss Watson Trust Under Agreement dated March 28, 2007 and the Karol A. Foss Irrevocable Grandchildren's Trust dated December 22, 2008. Mr. Foss has sole voting power and dispositive power over such shares but Ms. Foss Watson and her Trusts have the right to receive any dividends on and any proceeds from the sale of such shares. /s/ Donald A. Foss 2011-11-03