-----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, NwPlBIYeFMOu7JipPB5diuOWJVkIZdm1HhgqTZ/Y8CLZTVNB1CfwC6mlITAO36m7 JJ2Vk8hYedFIyjZZkko74w== 0000944695-03-000070.txt : 20031112 0000944695-03-000070.hdr.sgml : 20031112 20031112191041 ACCESSION NUMBER: 0000944695-03-000070 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20031103 FILED AS OF DATE: 20031112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SAMALYA MHAYSE G CENTRAL INDEX KEY: 0001269362 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13754 FILM NUMBER: 03995463 BUSINESS ADDRESS: STREET 1: ALLMERICA FINANCIAL CORP STREET 2: 1455 LINCOLN PARKWAY CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: 5088556404 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ALLMERICA FINANCIAL CORP CENTRAL INDEX KEY: 0000944695 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 043263626 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 440 LINCOLN ST CITY: WORCESTER STATE: MA ZIP: 01653 BUSINESS PHONE: 5088551000 MAIL ADDRESS: STREET 1: 440 LINCOLN ST CITY: WORCESTER STATE: MA ZIP: 01653 3 1 primary_doc.xml PRIMARY DOCUMENT X0201 3 2003-11-03 0 0000944695 ALLMERICA FINANCIAL CORP AFC 0001269362 SAMALYA MHAYSE G ALLMERICA FINANCIAL 440 LINCOLN STREET WORCESTER MA 01653 0 1 0 0 President of Subsidiary Common Stock 827 D Common Stock 2212 I 401(k) Plan Employee Stock Option (right to buy) 63.63 2009-07-12 Common Stock 8000 D Employee Stock Option (right to buy) 44.56 2010-02-20 Common Stock 8600 D Employee Stock Option (right to buy) 57 2011-02-18 Common Stock 9000 D Employee Stock Option (right to buy) 44.05 2012-01-02 Common Stock 10000 D Employee Stock Option (right to buy) 14.94 2013-01-17 Common Stock 16000 D Based on Plan statement dated November 11, 2003. Exercisable in five equal annual installments beginning on 07/12/00. Exercisable in five equal annual installments beginning on 02/20/01. Exercisable in five equal annual installments beginning on 02/18/02. Exercisable 25% on 01/02/03, 25% on 01/02/04 and 50% on 01/02/05. Exercisable 25% on 01/17/04, 25% on 01/17/05 and 50% on 01/17/06. Exhibit List Exhibit 24 - Confirming Statement /s/Charles F. Cronin, Attorney-in-fact 2003-11-12 EX-24 3 samalyamhayse-confstmt.txt CONFIRMING STATEMENT Exhibit 24 CONFIRMING STATEMENT This Statement confirms that the undersigned, Mhayse G. Samalya has authorized and designated Charles F. Cronin to execute and file on the undersigned's behalf, individually and in the undersigned's capacity as a trustee for various family trusts, all Forms 3, 4 and 5 (including any amendments thereto) that the undersigned may be required to file with the Securities and Exchange Commission as a result of the undersigned's ownership of or transactions in securities of Allmerica Financial Corporation. The authority of Charles F. Cronin under this Statement shall continue until the undersigned is no longer required to file Forms 3, 4 and 5 with regard to the undersigned's ownership of or transactions in the securities of Allmerica Financial Corporation, unless earlier revoked in writing. The undersigned acknowledges that Charles F. Cronin is not assuming any of the undersigned's responsibilities to comply with Section 16 of the Securities Exchange Act of 1934. Dated: November 7, 2003 /s/Mhayse G. Samalya -----END PRIVACY-ENHANCED MESSAGE-----