-----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, DbZNEWij+BD8CqhwcGQUQ1+9Vj94yfGcyr4yqaISEfAblE/1SmFoYbg+VDeUNqzZ qr5lBNZgAvb3Sdjy1kqQ8w== 0000895813-01-500077.txt : 20010711 0000895813-01-500077.hdr.sgml : 20010711 ACCESSION NUMBER: 0000895813-01-500077 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010706 FILED AS OF DATE: 20010710 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: AMERICAN COUNTRY HOLDINGS INC CENTRAL INDEX KEY: 0000315411 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 060995978 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-22922 FILM NUMBER: 1677705 BUSINESS ADDRESS: STREET 1: 222 N LASALLE STREET STREET 2: C/O JOHN DE ELORZA CITY: CHICAGO STATE: IL ZIP: 60601-1105 BUSINESS PHONE: 3124562000 MAIL ADDRESS: STREET 1: 222 N LASALLE STREET CITY: CHICAGO STATE: IL ZIP: 60601-1105 FORMER COMPANY: FORMER CONFORMED NAME: WESTERN SYSTEMS CORP DATE OF NAME CHANGE: 19970326 FORMER COMPANY: FORMER CONFORMED NAME: WESTERN TRANSMEDIA CO INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: VIGILANCE SYSTEMS CORP DATE OF NAME CHANGE: 19920202 COMPANY DATA: COMPANY CONFORMED NAME: SOLOMON MARTIN L CENTRAL INDEX KEY: 0001012912 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O TDS STREET 2: 30 N LASALLE ST SUITE 400 CITY: CHICAGO STATE: IL ZIP: 60602 BUSINESS PHONE: 3126301900 MAIL ADDRESS: STREET 1: C/O TDS STREET 2: 30 N LASALLE CITY: CHICAGO STATE: IL ZIP: 60602 4 1 x0710-4_solomon.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person: Martin L. Solomon P.O. Box 70 Coconut Grove, Florida 33233 U.S.A. 2. Issuer Name and Ticker or Trading Symbol: American Country Holdings Inc. ACHI 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement for Month/Year: June 2001 5. If Amendment, Date of Original (Month/Year): August 1997 6. Relationship of Reporting Person(s) to Issuer (Check all applicable): (x) Director (x) 10% Owner ( ) Officer (give title below) ( ) Other (specify below): 7. Individual or Joint/Group Filing (Check Applicable Line): (x) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 5. Amount of 2. Trans- Securities 6. Owner- action 3. Trans- Beneficially ship Form: 1. Title of Date action 4. Securities Acquired Owned at End Direct (D) or 7. Nature of Indirect Security (Month/ Code (A) or Disposed of (D) of Month Indirect (I) Beneficial Ownership (Instr. 3) Day/Year) (Instr. 8) (Instr. 3, 4 and 5) (Instr. 3 and 4) (Instr. 4) (Instr. 4) ----------- --------- ---------- ---------------------- ---------------- ------------- --------------------- Code V Amount (A)or(D) Price ---- - ------ -------- ----- Common Stock, 7/6/01 S V 555,471 A $1.9035 2,568,056 D $.01 par value
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 10. 9. Owner- 5. Number ship Number of Deri- Form of 11. 2. of Deriv- vative Deri- Nature Conver- ative 8. Securi- vative of sion or Secur- Price ties Secur- Indi- Exer- 3. ities 7. of Benefi- ity: rect 1. cise Trans- Acquired 6. Title and Deriv- cially Direct Benefi- Title of Price action 4. (A) or Date Exer- Amount of ative Owned at (D) or cial Deriv- of Date Trans- Disposed cisable and Underlying Secur- End of Indirect Owner- ative Deriv- (Month/ action of (D) Expiration Securities ity Month (I) ship Security ative Day/ Code (Instr. 3, Date(Month/ (Instr. 3 (Instr. (Instr. (Instr. (Instr. (Instr. 3) Security Year) (Instr. 8) 4 and 5) Day/Year) and 4) 5) 4) 4) 4) ---------- -------- ------- ---------- ---------- --------------- ---------------- ------ -------- -------- ------- Date Expir- Amount or Exer- ation Number of Code V (A) (D) cisable Date Title Shares ---- - --- --- ------- ------ ----- --------- Option $2.18 6/7/01 A 5,000 6/7/01 6/6/06 Common 5,000 5,000 D Stock, $.01 par value
Explanation of Responses: SIGNATURE OF REPORTING PERSON: /s/ Martin L. Solomon ----------------------------- Martin L. Solomon Dated: July 9, 2001 -----END PRIVACY-ENHANCED MESSAGE-----