-----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, V9Gq/eHrr8ySJAz1pc3gVv3eTq9wNo/JH46H18xQ1aGs5SANHdYanac6GaOmnsXs hH4bB59zXXGACqplwBrZbg== 0000950137-02-000704.txt : 20020414 0000950137-02-000704.hdr.sgml : 20020414 ACCESSION NUMBER: 0000950137-02-000704 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20020214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: EBIX COM INC CENTRAL INDEX KEY: 0000814549 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 770021975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-38591 FILM NUMBER: 02547042 BUSINESS ADDRESS: STREET 1: 3501 ALGONQUIN RD STREET 2: STE 500 CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 BUSINESS PHONE: 8475063100 MAIL ADDRESS: STREET 1: 3501 ALGONQUIN ROAD CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 FORMER COMPANY: FORMER CONFORMED NAME: DELPHI INFORMATION SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19920703 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MILLS WAYNE WILLIAM CENTRAL INDEX KEY: 0000930294 IRS NUMBER: 474684162 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITE 29D CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 6125423737 MAIL ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITW 29D CITY: PLYMOUTH STATE: MN ZIP: 55441 SC 13G/A 1 c67533a2sc13ga.txt AMENDMENT NO. 2 TO SCHEDULE 13G SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 SCHEDULE 13G/A (RULE 13d-102) Information to be Included in Statements Filed Pursuant to Rules 13d-1(b), (c), and (d) and Amendments Thereto Filed Pursuant to Rules 13d-2(b). Under the Securities Exchange Act of 1934 (Amendment No. 2)(1) EBIX.COM, INC. - -------------------------------------------------------------------------------- (Name of Issuer) COMMON STOCK, $0.10 par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 278715107 - -------------------------------------------------------------------------------- (CUSIP Number) December 31, 2001 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) (1)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 of the Act, but shall be subject to all other provisions of the Act (however, see the Notes). CUSIP NO. 278715107 13G PAGE 2 OF 5 PAGES - -------------------------------------------------------------------------------- 1 Names of Reporting Persons/I.R.S. Identification Nos. of Above Persons (Entities Only) Wayne William Mills - -------------------------------------------------------------------------------- 2 Check the Appropriate Box if a Member of a Group (a) [ ] (See Instructions) (b) [X] - -------------------------------------------------------------------------------- 3 SEC Use Only - -------------------------------------------------------------------------------- 4 Citizenship or Place of Organization USA - -------------------------------------------------------------------------------- Number of 5 Sole Voting Power Shares 996,500 ----------------------------------------------------- Beneficially 6 Shared Voting Power 0 Owned by ----------------------------------------------------- 7 Sole Dispositive Power Each 996,500 ----------------------------------------------------- Reporting 8 Shared Dispositive Power Person With 0 - -------------------------------------------------------------------------------- 9 Aggregate Amount Beneficially Owned by Each Reporting Person 996,500 - -------------------------------------------------------------------------------- 10 Check if the Aggregate Amount in Row (9) Excludes Certain Shares [ ] (See Instructions) - -------------------------------------------------------------------------------- 11 Percent of Class Represented by Amount in Row (9) 5.4% (Based on 18,326,182 shares outstanding as of 11/9/01, as reported by the Issuer on its Form 10-Q for the quarter ended 9/30/01.) - -------------------------------------------------------------------------------- 12 Type of Reporting Person (See Instructions) IN - -------------------------------------------------------------------------------- Page 2 of 5 pages Item 1. (a) Name of Issuer: EBIX.COM, INC. (b) Address of Issuer's Principal Executive Office: 1900 E. Golf Road, Schaumburg, IL 60173 Item 2. (a) Name of Person Filing: Wayne William Mills (b) Address of Principal Business Office: 5020 Blake Road South, Edina, MN 55436 (c) Citizenship: United States (d) Title of Class of Securities: Common Stock, $.10 par value (e) CUSIP Number: 278715107 Item 3. If this Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a: (a) [ ] Broker or dealer registered under Section 15 of the Exchange Act. (b) [ ] Bank as defined in Section 3(a)(6) of the Exchange Act. (c) [ ] Insurance company as defined in Section 3(a)(19) of the Exchange Act. (d) [ ] Investment company registered under Section 8 of the Investment Company Act. (e) [ ] An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E); (f) [ ] An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F); (g) [ ] A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G); (h) [ ] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act; (i) [ ] A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act; (j) [ ] Group, in accordance with Rule 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: 996,500 (Includes 525,000 shares owned by Sea Spray Ltd., a foreign corporation of which the Reporting Person is the sole shareholder.) (b) Percent of Class: 5.4% (c) Number of Shares as to Which Such Person Has: (i) sole power to vote or direct the vote: 996,500 (ii) shared power to vote or direct the vote: 0 (iii) sole power to dispose or direct the disposition of: 996,500 (iv) shared power to dispose or to direct the disposition of: 0 Item 5. Ownership of Five Percent or Less of a Class. If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ]. Item 6. Ownership of More than Five Percent on Behalf of Another Person. Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security being Reported on by the Parent Holding Company. Not applicable. Item 8. Identification and Classification of Members of the Group. Not applicable. Item 9. Notice of Dissolution of Group. Not applicable. Item 10. Certifications. (a) Not applicable. (b) By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect. 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. Dated: February 14, 2002 S/ Wayne W. Mills By: ---------------------------------- Wayne W. Mills -----END PRIVACY-ENHANCED MESSAGE-----