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*
(Street)
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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)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2011 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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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 | 1,300(4) | D | |||||||||||||
Common Stock, $1.25 par value | 12/31/2011 | J(1)(2) | 3,234(1)(2) | A | $0 | 1,028,071(3)(4) | I | See(3)(4) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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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, 2011, pursuant to the mandatory provisions of the agreement of JRB Interests, Ltd., a Texas partnership (the "Partnership"), the shares of the Issuer's common stock, $1.25 par value ("Common Stock"), owned by the Partnership and attributable to the general and limited partner interests of the Partnership were reallocated such that (a) the Common Stock owned by the Partnership and attributable to the general and Class C limited partner interests of the Partnership held by the Issue Trust for Lee M. Vogel (the "Vogel Trust"), for which Mr. Vogel serves as a co-trustee, declined by 31,867 shares; (b) the Common Stock owned by the Partnership and attributable to the general partner interest of the Partnership held by Mr. Vogel individually declined by 10 shares; |
2. (continuation of Footnote 1) and (c) the Common Stock owned by the Partnership and attributable to the Class B limited partner interests of the Partnership held by the Vogel Trust, for which Mr. Vogel serves as a co-trustee, increased by 35,111 shares. Mr. Vogel disclaims beneficial ownership of the shares of Common Stock owned by the Partnership except to the extent of his pecuniary interest therein. |
3. Mr. Vogel is a general partner of the Partnership and, in that capacity, 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. The shares reported include 1,022,273 shares of Common Stock owned by the Partnership, which consist of: (a) 1,022,088 shares attributable to the limited and general partner interests of the Partnership held by the Vogel Trust, for which Mr. Vogel serves as co-trustee, and (b) 185 shares attributable to the general partner interest of the Partnership held by Mr. Vogel individually. Mr. Vogel disclaims beneficial ownership of the shares of Common Stock owned by the Partnership except to the extent of his pecuniary interest therein. The shares reported also include 5,798 shares of Common Stock owned by the Lee M. Vogel Revocable Trust dated as of March 15, 2005, for which Mr. Vogel is a beneficiary and serves as trustee. |
4. Mr. Vogel is a party to a Voting Agreement dated October 31, 2004 with members of the extend family of Walter E. Bixby, Jr., pursuant to which Voting Agreement Mr. Vogel has the sole voting power for all shares of Common Stock owned by the family group. Except for the shares reported herein, Mr. Vogel disclaims beneficial ownership in all shares of Common Stock subject to the Voting Agreement as he has no pecuniary interest in them. |
A. Craig Mason, Jr., Attorney in Fact for Lee M. Vogel | 02/23/2012 | |
** 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |