-----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, PRQCR6szZw6pIIeCB8Kv+bn4zZUW1FWBDP4Bc3qaSYS/aZDw8wt4OMTvmhf71nLt mxTfKq5AHHf/lgt0DiQJBw== 0000950133-01-000589.txt : 20010223 0000950133-01-000589.hdr.sgml : 20010223 ACCESSION NUMBER: 0000950133-01-000589 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CLARK/BARDES HOLDINGS INC CENTRAL INDEX KEY: 0001063980 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 522103926 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-54813 FILM NUMBER: 1542831 BUSINESS ADDRESS: STREET 1: 102 S WYNSTONE PARK DR STREET 2: STE 200 CITY: NORTH BARRINGTON STATE: IL ZIP: 60010 BUSINESS PHONE: 8473045800 MAIL ADDRESS: STREET 1: 102 S WYNSTONE PARK DR STREET 2: STE 200 CITY: NORTH BARRINGTON STATE: IL ZIP: 60010 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LIFE INVESTORS INSURANCE CO OF AMERICA CENTRAL INDEX KEY: 0000059386 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 420191090 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 4333 EDGEWOOD ROAD NE CITY: CEADAR RAPIDS STATE: IA ZIP: 52499 BUSINESS PHONE: 3193988511 SC 13G 1 w45404sc13g.txt CLARK/BARDES HOLDINGS, INC. 1 - -------------------------------------------------------------------------------- SEC 1745 (6-00) POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER. - -------------------------------------------------------------------------------- ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0145 ------------------------------ Expires: October 31, 2002 ------------------------------ Estimated average burden hours per response. . . 14.9 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. ___________)* CLARK/BARDES HOLDINGS, INC. --------------------------- (Name of Issuer) COMMON STOCK ------------ (Title of Class of Securities) 180668 10 5 ----------- (CUSIP Number) SEPTEMBER 11, 2000 ------------------ (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ X ] Rule 13d-1(b) [ ] Rule 13d-1(c) [ ] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section Bof the Act but shall be subject to all other provisions of the Act (however, see the Notes). 2 CUSIP No. 180668 10 5 - ------------------------------------------------------------------------------- 1. Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). LIFE INVESTORS INSURANCE COMPANY OF AMERICA - ------------------------------------------------------------------------------- 2. Check the Appropriate Box if a Member of a Group (See Instructions) (a) ....................................................... (b) ....................................................... - ------------------------------------------------------------------------------- SEC Use Only 3. ............................................................ - ------------------------------------------------------------------------------- 4. Citizenship or Place of Organization IOWA - ------------------------------------------------------------------------------- Number of Shares Beneficially Owned by Sole Voting Power Each Reporting 5. .....1,150,839.................................... Person With - ------------------------------------------------------------------------------- Shared Voting Power 6. .................................................. - ------------------------------------------------------------------------------- 3 Sole Dispositive 7. Power.......1,150,839............................. - ------------------------------------------------------------------------------- Shared Dispositive Power 8. .................................................. - ------------------------------------------------------------------------------- Aggregate Amount Beneficially Owned by Each Reporting 9. Person..........1,150,839................................... - ------------------------------------------------------------------------------- Check if the Aggregate Amount in Row (9) Excludes Certain 10. Shares (See Instructions)................................... - ------------------------------------------------------------------------------- Percent of Class Represented by Amount in Row (9) 11. ..................9.1%...................................... - ------------------------------------------------------------------------------- 12. Type of Reporting Person (See Instructions) - ------------------------------------------------------------------------------- ...........IC.................................................................. - ------------------------------------------------------------------------------- SCHEDULE 13G ITEM 1. Name of Issuer (a) CLARK/BARDES HOLDINGS, INC. Address of Issuer's Principal Executive Offices (b) 102 S. WYNSTONE PARK DRIVE, SUITE 200, NORTH BARRINGTON, IL 60010 4 ITEM 2. Name of Person Filing (a) LIFE INVESTORS INSURANCE COMPANY OF AMERICA Address of Principal Business Office or, if none, Residence (b) 4333 EDGEWOOD ROAD, NE, CEDAR RAPIDS, IOWA 52499 Citizenship (c) IOWA Title of Class of Securities (d) COMMON CUSIP Number (e) 180668 10 5 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO SECTIONS 240.13d-1(b) OR 240.13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A: (a) [ ] Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o). (b) [ ] Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c). (c) [ X ] Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c). (d) [ ] Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8). (e) [ ] An investment adviser in accordance with Section 240.13d-1(b)(1)(ii)(E); (f) [ ] An employee benefit plan or endowment fund in accordance with Section 240.13d-1(b)(1)(ii)(F); 5 (g) [ ] A parent holding company or control person in accordance with Section 240.13d-1(b)(1)(ii)(G); (h) [ ] A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813); (i) [ ] A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3); (j) [ ] Group, in accordance with Section 240.13d-1(b)(1)(ii)(J). ITEM 4. OWNERSHIP. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: 1,150,839 . --------------- (b) Percent of class: 9.1% . -------------------------------- (c) Number of shares as to which the person has: (i) Sole power to vote or to direct the vote 1,150,839 . -------------------- (ii) Shared power to vote or to direct the vote . ------------------ (iii) Sole power to dispose or to direct the disposition of 1,150,839 . ----------------- (iv) Shared power to dispose or to direct the disposition of . --------------- ITEM 5 THROUGH ITEM 10 NOT APPLICABLE 6 SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. LIFE INVESTORS INSURANCE COMPANY OF AMERICA February 12, 2001 ---------------------------------- Date s/ JAMES R. TREFZ ---------------------------------- Signature James R. Trefz, Vice President Name/Title -----END PRIVACY-ENHANCED MESSAGE-----