0001567619-21-017235.txt : 20210917 0001567619-21-017235.hdr.sgml : 20210917 20210917160109 ACCESSION NUMBER: 0001567619-21-017235 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210904 FILED AS OF DATE: 20210917 DATE AS OF CHANGE: 20210917 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Franklin Jeffrey Ross CENTRAL INDEX KEY: 0001713860 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03722 FILM NUMBER: 211260345 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD NE CITY: ATLANTA STATE: GA ZIP: 30319 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 4 1 doc1.xml FORM 4 X0306 4 2021-09-04 0 0000008177 ATLANTIC AMERICAN CORP AAME 0001713860 Franklin Jeffrey Ross 4370 PEACHTREE ROAD, N.E. ATLANTA GA 30319 0 1 0 0 VP, CFO & Secretary Common Stock 2021-09-04 4 F 0 3500 3.99 D 38350 D Common Stock 2056 I By 401(k) Plan Represents the number of shares of common stock that have been withheld by the issuer to satisfy its income tax withholding and remittance obligations in connection with the reporting person's net share settlement upon the vesting of 10,000 shares of restricted stock and does not represent a sale by the reporting person. Based on most recent plan statement. Shares held by the 401(k) plan were previously aggregated with the shares directly held by the reporting person. Shares held by the 401(k) plan are now being reported separately as indirectly held by the reporting person. /s/ J. Ross Franklin 2021-09-17