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*
BIXBY ANGELINE I

(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)
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)
X Form filed by One Reporting Person
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 12/31/2003 J(1)(2) 12,249 A (1)(2) $565,903.8 D
Common Stock, $1.25 par value 12/31/2003 J(1)(2) 36,678 D (1)(2) 2,152,207 I See Footnotes(3)
Common Stock, $1.25 par value 12/31/2003 J 0 D (1)(2) 353,688 D
Common Stock, $1.25 par value 12/31/2003 J 0 D (1)(2) 375,975 I See Footnotes(4)
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
Explanation of Responses:
1. Effective on December 31, 2003, pursuant to the mandatory provisions of the agreement of WEB Interests, Ltd., a Texas partnership (the "Partnership"), (a) the shared voting power and an indirect pecuniary interest in 36,306 shares of common stock, $1.25 par value of Kansas City Life Insurance Company ("Common Stock"), owned by the Partnership were transferred from Ms. O'Connor in her capacity as a co-trustee of the Walter E. Bixby, Jr. Revocable Trust dated July 28, 1999, as amended ("WEB Trust" ), a Class C limited partner of the Partnership, to the Class B limited partners, (b) the sole voting power and an indirect pecuniary interest in 4 shares of Common Stock owned by the Partnership were transferred from Ms. O'Connor, as a general partner in her individual capacity, to certain other partners
2. (c) the sole voting power and an indirect pecuniary interest in 12,219 shares were transferred to Ms. O'Connor in her capacity as the sole trustee of each of the GST Angeline I. O'Connor Trust and the Issue Trust for Angeline I. O'Connor (collectively, the "AIO Trusts"), each as a Class B limited partner, from certain other partners, (d) the shared voting power and an indirect pecuniary interest in 368 shares of Common Stock owned by the Partnership were transferred from Ms. Connor in her capa city as a co-trustee of the WEB Trust, a general partner, to certain other partners, and (e) the shared voting power and an indirect pecuniary interest in 30 shares of Common Stock owned by the Partnership were transferred to Ms. O'Connor in her capacity as co-trustee of the WEB Trust from the general partners to the Class A limited partners
3. As a general partner of the Partnership, Ms. O'Connor shares with the WEB Trust (a general partner of the Partnership) and the other trustees of the WEB Trust (each of whom is also a general partner of the Partnership) the power to dispose of all of the 2,358,340 shares of Common Stock owned by the Partnership. These shares include: (a) 2,049,140 shares for which Ms. O'Connor as a limited partner and a general partner of the Partnership, in her capacity as a co-trustee of the WEB Trust, has the shared power to vote and an indirect pecuniary interest, (b) 205 shares for which Ms. O'Connor as an individual general partner of the Partnership has the sole power to vote and an indirect pecuniary interest, and (c) 102,862 shares for which Ms. O'Connor as a limited partner, in her capacity as the sole trustee of each of the AIO Trusts, has the sole power to vote and an indirect pecuniary interest
4. As a co-trustee of the Walter E. Bixby Descendants Trust with Walter E. Bixby and Robert Philip Bixby, Ms. O'Connor shares the power to vote and dispose of these shares of Common Stock.
Angeline I. O'Connor 02/18/2004
** 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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