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