0001567619-21-005417.txt : 20210302 0001567619-21-005417.hdr.sgml : 20210302 20210302175849 ACCESSION NUMBER: 0001567619-21-005417 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20210104 FILED AS OF DATE: 20210302 DATE AS OF CHANGE: 20210302 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CLARK FRED JR CENTRAL INDEX KEY: 0001239490 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18649 FILM NUMBER: 21705676 MAIL ADDRESS: STREET 1: 661 EAST DAVIS CITY: ELBA STATE: AL ZIP: 36323 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL SECURITY GROUP INC CENTRAL INDEX KEY: 0000865058 STANDARD INDUSTRIAL CLASSIFICATION: LIFE INSURANCE [6311] IRS NUMBER: 631020300 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 661 E DAVIS ST CITY: ELBA STATE: AL ZIP: 36323 BUSINESS PHONE: 2058972273 4 1 doc1.xml FORM 4 X0306 4 2021-01-04 0 0000865058 NATIONAL SECURITY GROUP INC NSEC 0001239490 CLARK FRED JR 2100 FLOWERS ROAD MATHEWS AL 36052 1 0 0 0 Common Stock 2021-01-04 5 G 0 3720 D 74987 D Common Stock 2021-01-04 5 G 0 3720 A 26338 I By Children Common Stock 2021-01-11 5 G 0 1748 D 73239 D Common Stock 2021-01-11 5 G 0 1748 A 28086 I By Children Shares were disposed of via bona fide gift. Shares were acquired via bona fide gift. Brian R. McLeod, Attorney-in-fact 2021-03-02