0001567619-21-003980.txt : 20210216
0001567619-21-003980.hdr.sgml : 20210216
20210216154644
ACCESSION NUMBER: 0001567619-21-003980
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20201231
FILED AS OF DATE: 20210216
DATE AS OF CHANGE: 20210216
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Howell Robin Robinson
CENTRAL INDEX KEY: 0001551391
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-03722
FILM NUMBER: 21637460
MAIL ADDRESS:
STREET 1: 3656 TUXEDO ROAD NW
CITY: ATLANTA
STATE: GA
ZIP: 30305
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: ATLANTIC AMERICAN CORP
CENTRAL INDEX KEY: 0000008177
STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311]
IRS NUMBER: 581027114
STATE OF INCORPORATION: GA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 4370 PEACHTREE RD NE
CITY: ATLANTA
STATE: GA
ZIP: 30319
BUSINESS PHONE: 4042665500
MAIL ADDRESS:
STREET 1: 4370 PEACHTREE ROAD
CITY: ATLANTA
STATE: GA
ZIP: 30319
5
1
doc1.xml
FORM 5
X0306
5
2020-12-31
0
0
0
0000008177
ATLANTIC AMERICAN CORP
AAME
0001551391
Howell Robin Robinson
4370 PEACHTREE ROAD, N.E.
ATLANTA
GA
30319
1
0
0
0
Common Stock
2020-02-27
5
G
0
1025
0
D
21900
D
Common Stock
61956
I
Custodian For Children
Common Stock
2020-02-27
5
G
0
1025
0
A
3954281
I
Trust Beneficiary
Common Stock
2175
I
By IRA Account
Common Stock
809884
I
By Spouse
Common Stock
358556
I
Trust F/B/O Children
Mrs. Howell disclaims beneficial ownership of all such shares.
Beneficiary under trust holding shares for her benefit and over which her mother, Harriett J. Robinson, is trustee.
Mrs. Howell has an indirect interest in the following shares of Common Stock owned by her husband, Hilton H. Howell, Jr.: 535,940 shares owned directly and 273,944 shares owned through his 401(k) plan. Mrs. Howell disclaims beneficial ownership of all such shares.
Shares held in a trust for the benefit of Mrs. Howell's children and over which her mother serves as trustee. Mrs. Howell disclaims beneficial ownership of all such shares.
Robin R. Howell
2021-02-16