-----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, J6T0GH4Scn09c+74ASih24dTWFeO4FyyGvqgD1lPG8h4gqB/iXjf5cRpNNtmOEED nFk4IfSu3K6zGE5TS1/z0Q== 0001209191-04-030074.txt : 20040607 0001209191-04-030074.hdr.sgml : 20040607 20040607165142 ACCESSION NUMBER: 0001209191-04-030074 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040603 FILED AS OF DATE: 20040607 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: BANCINSURANCE CORP CENTRAL INDEX KEY: 0000276400 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 310790882 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 10TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 BUSINESS PHONE: 6142282800 MAIL ADDRESS: STREET 1: 250 EAST BROAD STREET STREET 2: 10TH FLOOR CITY: COLUMBUS STATE: OH ZIP: 43215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SOKOL SAUL CENTRAL INDEX KEY: 0000938331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-08738 FILM NUMBER: 04852224 BUSINESS ADDRESS: STREET 1: 3242 EAST MAIN STREET CITY: COLUMBUS STATE: OH ZIP: 43213-2788 BUSINESS PHONE: 6142282800 MAIL ADDRESS: STREET 1: 3242 EAST MAIN STREET CITY: COLUMBUS STATE: OH ZIP: 43213-2788 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-06-03 0 0000276400 BANCINSURANCE CORP BCIS 0000938331 SOKOL SAUL 250 E. BROAD ST. 10TH FLOOR COLUMBUS OH 43215 1 0 0 0 Common Shares 2004-06-03 5 G 0 E 1675.0000 0 A 1675.0000 D Common Shares 2004-06-03 4 M 0 2000.0000 6.7500 A 3675.0000 D Common Shares 2004-06-03 4 F 0 1675.0000 8.0600 D 2000.0000 D Common Shares 2004-06-03 5 G 0 E 2000.0000 0 D 0 D Common Shares 2004-06-03 5 G 0 E 1675.0000 0 D 250337.0000 I By The Saul Sokol & Phyllis D. Sokol Family Trust Common Shares 2004-06-03 5 G 0 E 2000.0000 0 A 252337.0000 I By The Saul Sokol & Phyllis D. Sokol Family Trust Option to purchase common shares 6.7500 2004-06-03 4 M 0 2000.0000 0 D 1995-06-14 2004-06-14 Common Shares 2000.0000 0 D These Common Shares are beneficially owned by The Saul Sokol and Phyllis D. Sokol Family Trust, a revocable trust. Saul Sokol is the sole trustee of such trust. As the sole trustee, Saul Sokol is empowered to exercise all rights with regards to such Common Shares, revoke the trust and amend the trust. /s/Saul Sokol 2004-06-07 -----END PRIVACY-ENHANCED MESSAGE-----