-----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, FnN0cKnjByz0BB0VXAP6EWZB2XTYo3XzlcDVceYZ+lhT7P+rml4Plm7LHekivbhE F33DzvCJgnj2IGKmvj0Szw== 0001209191-04-009534.txt : 20040213 0001209191-04-009534.hdr.sgml : 20040213 20040213100805 ACCESSION NUMBER: 0001209191-04-009534 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040213 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CITIZENS INC CENTRAL INDEX KEY: 0000024090 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 840755371 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 400 EAST ANDERSON LANE CITY: AUSTIN STATE: TX ZIP: 78752 BUSINESS PHONE: 5128377100 MAIL ADDRESS: STREET 1: 400 EAST ANDERSON LANE CITY: AUSTIN STATE: TX ZIP: 78752 FORMER COMPANY: FORMER CONFORMED NAME: CONTINENTAL INVESTORS LIFE INC DATE OF NAME CHANGE: 19881222 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: RILEY RICK D CENTRAL INDEX KEY: 0001054959 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-16509 FILM NUMBER: 04595194 BUSINESS ADDRESS: STREET 1: P O BOX 149151 CITY: AUSTIN STATE: TX ZIP: 78714-9151 BUSINESS PHONE: 5128377100 MAIL ADDRESS: STREET 1: P O BOX 149151 CITY: AUSTIN STATE: TX ZIP: 78714-9151 5 1 bdn12643_bdn1rdr.xml MAIN DOCUMENT DESCRIPTION X0201 5 2003-12-31 0 0 0 0000024090 CITIZENS INC CIA 0001054959 RILEY RICK D 5602 PAINTED VALLEY DRIVE AUSTIN TX 78759 1 1 0 0 CEO Class A Common Stock 2003-12-31 5 J 0 27439.000 0 A 410051.0000 D Class A Common Stock 2003-12-31 5 J 0 133.0000 0 A 1702.8233 D Class A Common Stock 2003-12-31 5 P 0 414.5766 0 A 2117.3999 D Class A Common Stock 2003-12-31 5 J 0 1444.0000 0 A 22062.0000 I Joint with spouse Class A Common Stock 2003-12-31 5 J 0 1278.0000 0 A 19527.0000 I Trustee for Spouse Class A Common Stock 2003-12-31 5 J 0 14916.0000 0 A 227940.000 I Trustee for Children These shares were received through a stock dividend. These shares were received through a stock dividend on Mr. Rick Riley's stock Investment Plan. These shares were purchased through a Stock Investment Plan These shares were received through a stock dividend. These shares were received through a stock dividend. These shares were received through a stock dividend. /s/ Rick D. Riley 2004-02-12 -----END PRIVACY-ENHANCED MESSAGE-----