-----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, Mou5NxO4dW9N32op6lmKxlS9fBHQXe7WbPvT/JEr+LLhMhHqFyWk44pSElesEaOb GRG/RHuY+JmNWWsRfvAtfQ== 0000912057-02-034183.txt : 20020830 0000912057-02-034183.hdr.sgml : 20020830 20020830142337 ACCESSION NUMBER: 0000912057-02-034183 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020830 FILED AS OF DATE: 20020830 COMPANY DATA: COMPANY CONFORMED NAME: BRIT INSURANCE HOLDINGS PLC CENTRAL INDEX KEY: 0001140037 OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 55 BISHOPSGATE STREET 2: LONDON ENGLAND UK CITY: EC2N 3A5 MAIL ADDRESS: STREET 1: 55 BISHOPSGATE STREET 2: LONDON ENGLAND UK CITY: EC2N 3A5 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: EBIX COM INC CENTRAL INDEX KEY: 0000814549 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER INTEGRATED SYSTEMS DESIGN [7373] IRS NUMBER: 770021975 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-15946 FILM NUMBER: 02754073 BUSINESS ADDRESS: STREET 1: 3501 ALGONQUIN RD STREET 2: STE 500 CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 BUSINESS PHONE: 8475063100 MAIL ADDRESS: STREET 1: 3501 ALGONQUIN ROAD CITY: ROLLING MEADOWS STATE: IL ZIP: 60008 FORMER COMPANY: FORMER CONFORMED NAME: DELPHI INFORMATION SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19920703 4 1 a2088475z4.txt FORM 4
- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ---------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ---------------------------- / / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287 LONGER SUBJECT TO EXPIRES: January 31, 2005 SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5 CONTINUE. SEE Section 30(h) of the Investment Company Act of 1940 ---------------------------- INSTRUCTION 1(b). (Print or Type Responses) - ----------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) Brit Insurance ebix.com, Inc. ("EBIX") to Issuer (Check all applicable) Director X 10% Owner ---- ---- - --------------------------------------------------------------------------------------------- Officer (give Other (Last) (First) (Middle) 3. I.R.S. Identification 4. Statement for ---- title ---- (specify Number of Reporting Month/Day/Year below) below Person, if an entity ----------------- ------------------ 55 Bishopsgate (voluntary) August 2002 - -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original _X_Form filed by One Reporting Person (Month/Day/Year) ___Form filed by More than One Londoon EC2N 3AS UK April 2001 Reporting Person - ----------------------------------------------------------------------------------------------------------------------------------- (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of 2. Trans- 2A. Deemed 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature Security action Execution action or Disposed of (D) Securities ship of In- (Instr. 3) Date Date, Code (Instr. 3, 4 and 5) Beneficially Form: direct if any (Instr. 8) Owned Follow- Direct Bene- (Month/ (Month/ ing Reported (D) or ficial Day/ Day/ ------------------------------------------ Transaction(s) Indirect Owner- Year) Year) (A) or (Instr. 3 (I) ship Code V Amount (D) Price and 4) (Instr. 4) (Instr. 4) - ----------------------------------------------------------------------------------------------------------------------------------- Common Stock, 08/28/2002 P 71,950 A 0.693 7,289,100 D $.10 par value - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (8-02) POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER.
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative Security 2. Conver- 3. Trans- 3A. Deemed 4. Transac- 5. Number of Deriv- 6. Date Exer- (Instr. 3) sion or action Execution tion Code ative Securities Ac- cisable and Ex- Exercise Date Date, (Instr. 8) quired (A) or Dis- piration Date Price of (Month/ if any posed of (D) (Month/Day/ Deriv- Day/ (Month/ (Instr. 3, 4, and 5) Year) ative Year) Day/ Security Year) -------------------------------------- ---------------- Date Expira- Exer- tion Code V (A) (D) cisable Date - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- 7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature lying Securities of of Deriv- ship of In- (Instr. 3 and 4) Deriv- ative Form direct ative Securi- of De- Bene- Secur- ties rivative ficial ity Bene- Secu- Own- (Instr. ficially rity: ership 5) Owned Direct (Instr. 4) ----------------------- Following (D) or Title Amount or Reported Indi- Number of Transaction(s) rect (I) Shares (Instr. 4) (Instr. 4) - ----------------------------------------------------------------------------------------------- 1 - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------- Explanation of Responses: /s/ Peter Goddard /s/ Matthew Scales August 30, 2002 ------------------------------------- ----------------- **Signature of Reporting Person Date **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, SEE Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 SEC 1474 (8-02)
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