-----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, JFY8zzLLjJMsVp2d4yF0fgkLsfeHQ+WA+tQoCqlWxXf8YFzZSAa/mRBp45HPfli8 HnzBBpdT6OGuNr3lGfyAAg== 0001209191-03-009194.txt : 20030630 0001209191-03-009194.hdr.sgml : 20030630 20030630155824 ACCESSION NUMBER: 0001209191-03-009194 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030630 FILED AS OF DATE: 20030630 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ATLANTIC AMERICAN CORP CENTRAL INDEX KEY: 0000008177 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 581027114 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4370 PEACHTREE RD NE CITY: ATLANTA STATE: GA ZIP: 30319 BUSINESS PHONE: 4042665500 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD CITY: ATLANTA STATE: GA ZIP: 30319 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROBINSON J MACK CENTRAL INDEX KEY: 0001008889 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03722 FILM NUMBER: 03764440 BUSINESS ADDRESS: STREET 1: 4370 PEACHTREE RD CITY: ATLANTA STATE: GA ZIP: 30319 BUSINESS PHONE: 4042312111 MAIL ADDRESS: STREET 1: 4370 PEACHTREE RD CITY: ATLANTA STATE: GA ZIP: 30319 4 1 doc4.xml FORM 4 SUBMISSION X0101 42003-06-300000008177ATLANTIC AMERICAN CORP AAME0001008889ROBINSON J MACK 1110ChairmanCommon Stock2003-06-274P0100002.2975A8504263IBy SpouseMr. Robinson has a direct ownership of 744694 shares. Mr. Robinson also has an indirect ownership interest in 10717 shares held in a 401(k) Plan based on a plan statement as of December 31, 2002. Mr. Robinson also has an indirect ownership interest in 946702 shares owned by Delta Life Insurance Co. Mr. Robinson also has an indirect ownership interest in 8489263 shares, of which 517295 are owned directly by his spouse; 6720 shares held by spouse, jointly with grandson; 3953256 shares held directly by Trust for daughter, Robin Robinson, with spouse as Trustee; and, 4026992 shares held directly by Trust for daughter, Jill Robinson, with spouse as Trustee, all of which Mr. Robinson expressly disclaims beneficial ownership of such securities. Mr. Robinson also has an indirect ownership interest in 3411102 shares owned by Gulf Capital Services, for which Mr. Robinson holds a 24% interest in the Partnership. The remaining partnerships are held in equal shares by Trust for benefit of Mr. Robinson's daughters, with Mr. Robinson's spouse as Trustee. Mr. Robinson disclaims beneficial ownership for 76% of the securi ties held by Gulf Capital Services, representing the Trusts' proportionate partnership interest. Mr. Robinson also holds employee stock options to acquire 100000 shares of common stock granted under the Company's 1992 Incentive Plan at an exercise price of $3.374. Mr. Robinson also has an indirect ownership interest in options to acquire 5000 shares of common stock granted under the Company's 1996 Non-Employee Director Stock Option Plan at exercise prices ranging from $1.90 to $4.4375 held by his wife.Janie L. Ryan, POA2003-06-30 -----END PRIVACY-ENHANCED MESSAGE-----