Statement of Changes in Beneficial Ownership (4)
December 03 2019 - 4:04PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
Abernathey Andrew J. |
2. Issuer Name and Ticker or Trading Symbol
NATIONAL SECURITY GROUP INC
[
NSEC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director __X__ 10% Owner
_____ Officer (give title below) _____ Other (specify below)
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(Last)
(First)
(Middle)
819 30TH AVENUE SOUTH, SUITE 206A |
3. Date of Earliest Transaction
(MM/DD/YYYY)
11/29/2019 |
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(Street)
MOORHEAD, MN 56560
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
___ Form filed by One Reporting Person
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X
_ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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| Common Stock | 11/29/2019 | | P | | 1100 | A | $13.50 | 323658 | I | By Meridian Investments I, LLC (1) |
| Common Stock | 12/2/2019 | | P | | 7327 | A | $13.68 (2) | 330985 | I | By Meridian Investments I, LLC (1) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any | 4. Trans. Code
(Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4) | 8. Price of Derivative Security
(Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
| Explanation of Responses: |
| (1) | Andrew Abernathey is the President and sole director of Meridian Investments I, LLC and holds sole voting and dispositive power over the securities held by Meridian Investments I, LLC. |
| (2) | The price reported in column 4 is a weighted average price. These shares were purchased in multiple transactions at prices ranging from $13.10 to $13.95 inclusive. The reporting person undertakes to provide National Security Group, Inc., any security holder of National Security Group, Inc. or the staff of the Securities and Exchange Commission upon request, full information regarding the number of shares purchased at each separate price within the range set forth in this footnote. |
Reporting Owners
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| Reporting Owner Name / Address | Relationships |
| Director | 10% Owner | Officer | Other |
Abernathey Andrew J.
819 30TH AVENUE SOUTH
SUITE 206A
MOORHEAD, MN 56560 |
| X |
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Meridian Investments I, LLC
C/O ANDREW J. ABERNATHEY
819 30TH AVENUE SOUTH, SUITE 206A
MOORHEAD, MN 56560 |
| X |
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Signatures
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| /s/ Andrew J. Abernathey | | 12/3/2019 |
| **Signature of Reporting Person | Date |
| /s/ Andrew J. Abernathey as President of Meridian Investments I, LLC | | 12/3/2019 |
| **Signature of Reporting Person | Date |
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