SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
WHITEBOX ADVISORS LLC

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PENN TREATY AMERICAN CORP [ PTA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
07/13/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock(1) 07/13/2005 S 5,700 D $10.35 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(2) 07/13/2005 S 5,900 D $10.35 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(3) 07/13/2005 S 800 D $10.35 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(4) 07/13/2005 S 3,300 D $10.35 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(5) 07/13/2005 S 400 D $10.35 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(1) 07/13/2005 S 1,100 D $10.7 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(2) 07/13/2005 S 1,200 D $10.7 504.25(6)(7) I Refer to Footnote(8)(9)
Common Stock(4) 07/13/2005 S 600 D $10.7 504.25(6)(7) I Refer to Footnote(8)(9)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
WHITEBOX ADVISORS LLC

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Whitebox Diversified Convertible Arbitrage Partners, L.P.

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Whitebox Diversified Convertible Arbitrage Fund, L.P.

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Whitebox Diversified Convertible Arbitrage Fund, Ltd.

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Pandora Select Advisors, LLC

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Pandora Select Partners, L.P.

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Pandora Select Fund, L.P.

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
PANDORA SELECT FUND LTD

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Whitebox Diversified Convertible Arbitrage Advisors, LLC

(Last) (First) (Middle)
3033 EXCELSIOR BOULEVARD, SUITE 300

(Street)
MINNEAPOLIS MN 55416

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Reporting Person is Whitebox Convertible Arbitrage Partners, L.P. ("WCAP").
2. Reporting Person is Whitebox Hedged High Yield Partners, L.P. ("WHHYP").
3. Reporting Person is Whitebox Diversified Convertible Arbitrage Partners, L.P. ("WDCAP").
4. Reporting Person is Pandora Select Partners, L.P. ("PSP").
5. Each of WCAP, WHHYP, WDCAP, PSP and Whitebox Advisors, LLC beneficially own Convertible Subordinated Notes of which the Common Stock of Penn Treaty American Corporation is the underlying security.
6. This amount reflects a four for one reverse stock split of shares of common stock of the Issuer, effective July 8, 2005.
7. The general partner of WCAP, is Whitebox Convertible Arbitrage Advisors, LLC ("WCAA"), which manages accounts for the benefit of its clients WCAP, Whitebox Convertible Arbitrage Fund, L.P. ("WCAFLP") and Whitebox Convertible Arbitrage Fund, Ltd. ("WCAFLTD"); the general partner of WHHYP is Whitebox Hedged High Yield Advisors, LLC ("WHHYA"), which manages accounts for the benefit of its clients WHHYP, Whitebox Hedged High Yield Fund, L.P. ("WHYYFLP") and Whitebox Hedged High Yield Fund, Ltd. ("WHHYFLTD"). The managing member and controlling owner of each of WCAA and WHHYA is Whitebox Advisors, LLC. (Cont. in footnote 8)
8. The general partner of PSP is Pandora Select Advisors, LLC ("PSA"), which manages accounts for the benefit of its clients PSP, Pandora Select Fund, L.P. ("PSFLP") and Pandora Select Fund, Ltd. ("PSFLTD"). The general partner of WDCAP is Whitebox Diversified Convertible Arbitrage Advisors, LLC ("WDCAA"), which manages accounts for the benefit of its clients WDCAP Whitebox Diversified Convertible Arbitrage Fund, L.P. ("WDCAFLP") and Whitebox Diversified Convertible Arbitrage Fund, Ltd. ("WDCAFLTD"). The managing member and controlling owner of each of PSA and WDCAA is AJR Financial, LLC. Whitebox Advisors, LLC and AJR Financial, LLC each have the same sole owner and managing member. (Cont. in footnote 9)
9. Based on the relationships described herein, these entities may be deemed to constitute a "group" within the meaning of Rule 13d-5(b)(1) under the Securities Exchange Act of 1934. The filing of this statement shall not be construed as an admission that Whitebox Advisors, LLC, AJR Financial, LLC, WCCA, WHHYA, PSA, WDCAA, WCAP, WHHYP, PSP, WDCAP, WCAFLP, WHHYFLP, PSFLP, WDCAFLP, WCAFLTD, WHHYFLTD, PSFLTD and WDCAFLTD are a group, or have agreed to act as a group. Whitebox Advisors, LLC, AJR Financial, LLC, WCCA, WHHYA, PSA, WDCAA, WCAP, WHHYP, PSP, WDCAP, WCAFLP, WHHYFLP, PSFLP, WDCAFLP, WCAFLTD, WHHYFLTD, PSFLTD and WDCAFLTD each disclaim beneficial ownership of such shares of common stock except to the extent of their pecuniary interest in such shares.
Remarks:
For additional information also refer to the Form 4 filed concurrently herewith by the Reporting Persons.
/s/ Jonathan D. Wood, Chief Financial Officer 07/19/2005
/s/ Whitebox Diversified Convertible Arbitrage Advisors,LLC 07/19/2005
/s/ Whitebox Diversified Convertible Arbitrage Partners, LP 07/19/2005
/s/ Whitebox Diversified Convertible Arbitrage Fund,L.P. 07/19/2005
/s/ Whitebox Diversified Convertible Arbitrage Fund,Ltd. 07/19/2005
/s/ Pandora Select Advisors, LLC 07/19/2005
/s/ Pandora Select Partners, L.P. 07/19/2005
/s/ Pandora Select Fund, L.P. 07/19/2005
/s/ Pandora Select Fund, Ltd. 07/19/2005
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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