SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
HUDSON NANCY BIXBY

(Last) (First) (Middle)
3520 BROADWAY

(Street)
KANSAS CITY MO 64111

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
KANSAS CITY LIFE INSURANCE CO [ KCLI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2003
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock, $1.25 par value 07/28/2003 P(1) 34,966 A (1) $1,615,429.2 D
Common Stock, $1.25 par value 12/31/2003 J(2)(3) 43,258 A (2)(3) $1,998,519.6 I See Footnotes(2)(3)
Common Stock, $1.24 par value 12/31/2003 J(2)(3) 45,336 D (2)(3) 2,289,013 I See Footnotes(4)(5)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
HUDSON NANCY BIXBY

(Last) (First) (Middle)
3520 BROADWAY

(Street)
KANSAS CITY MO 64111

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
BIXBY JOSEPH R

(Last) (First) (Middle)
3520 BROADWAY

(Street)
KANSAS CITY MO 64111

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman of Board
Explanation of Responses:
1. Effective July 28, 2003, each of Joseph R. Bixby as trustee of the Joseph R. Bixby Revocable Trust dated December 18, 1997 and Margie Morris Bixby as trustee of the Margie Morris Bixby Revocable Trust dated December 18, 1997 transferred two-thirds of their general partnership interest in JRB Interests, Ltd. (the "Partnership"), including the shared power to vote 2,966,312 shares of common stock, $1.25 par value of the Kansas City Life Insurance Company ("Common Stock") and a pecuniary interest i n 34,966 shares of Common Stock, to Ms. Hudson in her capacity as co-trustee (with Richard L. Finn and Webb Gilmore) of the GST Nancy Bixby Hudson Trust and the Issue Trust for Nancy Bixby Hudson (collectively, the "NBH Trusts") for an aggregate price of $790,070. Mr. Finn and Mr. Gilmore do not have a pecuniary interest in the Common Stock
2. Effective on December 31, 2003, pursuant to the mandatory provisions of the agreement of the Partnership, (a) the shared voting power and an indirect pecuniary interest in 43,985 shares of Common Stock owned by the Partnership were transferred from Ms. Hudson in her capacity as a co-trustee of the NBH Trusts, each a Class C limited partner, to the Class B limited partners, (b) the sole voting power and an indirect pecuniary interest in 7 shares of Common Stock owned by the Partnership were trans ferred from Ms. Hudson, as an individual general partner, to the Class B limited partners; (c) the shared voting power and an indirect pecuniary interest in 1344 shares of Common Stock owned by the Partnership were transferred from Ms. Hudson in her capacity as co-trustee of the NBH Trusts, each a general partner, to the Class B limited partners
3. (d) the shared voting power and an indirect pecuniary interest in 43,258 shares of Common Stock owned by the Partnership were transferred to Ms. Hudson, as a Class B limited partner in her capacity as a co-trustee of each of the NBH Trusts, from the other non-Class B limited partners and general partners
4. As a general partner of the Partnership, Ms. Hudson shares with the other general partners of the Partnership the power to dispose of all of the 2,966,312 shares of Common Stock owned by the Partnership. These shares include: (a) 1,957,193 shares for which Ms. Hudson, in her capacity as a co-trustee of the NBH Trusts (each general and limited partners of the Partnership), has the shared power to vote and an indirect pecuniary interest, and (b) 252 shares for which Ms. Hudson as an individual ge neral partner of the Partnership has the sole power to vote and an indirect pecuniary interest
5. Ms. Hudson has the sole power to vote and dispose of these shares as the sole trustee of the Nancy Bixby Hudson Trust dated December 11, 1997, a Missouri trust.
Remarks:
signed by William A. Schalekamp as Power of Attorney
Nancy Bixby Hudson 02/17/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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