0001437749-21-000785.txt : 20210115
0001437749-21-000785.hdr.sgml : 20210115
20210115175759
ACCESSION NUMBER: 0001437749-21-000785
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20210115
FILED AS OF DATE: 20210115
DATE AS OF CHANGE: 20210115
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Brier Jack H.
CENTRAL INDEX KEY: 0001679388
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-55627
FILM NUMBER: 21533244
MAIL ADDRESS:
STREET 1: 4123 SW GAGE CENTER DRIVE
STREET 2: SUITE 240
CITY: TOPEKA
STATE: KS
ZIP: 66604
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: US Alliance Corp
CENTRAL INDEX KEY: 0001463913
STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311]
IRS NUMBER: 264824142
STATE OF INCORPORATION: KS
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4123 SW GAGE CENTER DRIVE
STREET 2: SUITE 240
CITY: TOPEKA
STATE: KS
ZIP: 66604
BUSINESS PHONE: 816-460-5807
MAIL ADDRESS:
STREET 1: 4123 SW GAGE CENTER DRIVE
STREET 2: SUITE 240
CITY: TOPEKA
STATE: KS
ZIP: 66604
FORMER COMPANY:
FORMER CONFORMED NAME: U. S. Alliance Corp
DATE OF NAME CHANGE: 20090512
4
1
rdgdoc.xml
FORM 4
X0306
4
2021-01-15
0001463913
US Alliance Corp
USAC
0001679388
Brier Jack H.
1303 SW FIRST AMERICAN PL
SUITE 200
TOPEKA
KS
66604
1
1
Chairman, President, and CEO
Restricted Common Stock
2021-01-15
4
P
0
32000
1.10
A
446800
D
/s/ Jack H. Brier
2021-01-15