0000355379-20-000010.txt : 20201112 0000355379-20-000010.hdr.sgml : 20201112 20201112145158 ACCESSION NUMBER: 0000355379-20-000010 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20201110 FILED AS OF DATE: 20201112 DATE AS OF CHANGE: 20201112 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Salem Anthony Michael CENTRAL INDEX KEY: 0001772791 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-10685 FILM NUMBER: 201305997 MAIL ADDRESS: STREET 1: 1075 OLD POST ROAD CITY: BEDFORD STATE: NY ZIP: 10506 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MIDWEST HOLDING INC. CENTRAL INDEX KEY: 0000355379 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 200362426 STATE OF INCORPORATION: NE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2900 SOUTH 70TH STREET STREET 2: SUITE 400 CITY: LINCOLN STATE: NE ZIP: 68506 BUSINESS PHONE: 402-489-8266 MAIL ADDRESS: STREET 1: 2900 SOUTH 70TH STREET STREET 2: SUITE 400 CITY: LINCOLN STATE: NE ZIP: 68506 FORMER COMPANY: FORMER CONFORMED NAME: MIDWEST HOLDING INC DATE OF NAME CHANGE: 20000101 FORMER COMPANY: FORMER CONFORMED NAME: MIDWEST NATIONAL CORP DATE OF NAME CHANGE: 19860123 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2020-11-10 0 0000355379 MIDWEST HOLDING INC. mdwt 0001772791 Salem Anthony Michael 1075 OLD POST ROAD BEDFORD NY 10506 1 1 0 0 Chief Executive Officer Voting Common Stock 2020-11-10 4 J 0 600077 0 D 0 I By Vespoint, LLC Group Voting Common Stock 2020-11-10 4 J 0 203298 0 A 203298 I By AMS Advisors, LLC Vespoint LLC distributed for no consideration 600,077 shares of voting common stock of Midwest Holding Inc. to its members on a pro rata basis. The reporting person retained indirect beneficial ownership of 203,298 shares of such voting common stock after giving effect to the distribution as described herein. The transaction described in this Form 4 represents an exempt change in form of beneficial ownership pursuant to Rule 16a-13. The reported share numbers in this Form 4 compared to the reporting person's previously filed Form 4 have been adjusted to reflect a 500 for 1 reverse stock split effectuated by Midwest Holding in August 2020. The shares of voting common stock reported as acquired in column 4 were previously reported as being indirectly held by the reporting person through Vespoint LLC. These shares were distributed for no consideration to AMS Advisors LLC in connection with the distribution noted in footnote 1 above. AMS Advisors is an entity controlled and owned by the reporting person. A. Michael Salem 2020-11-12