Annual Statement of Changes in Beneficial Ownership (5)
February 14 2020 - 9:45AM
Edgar (US Regulatory)
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
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Form 3 Holdings Reported
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Form 4 Transactions Reported
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL 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
*
BRUNSON WILLIAM L JR | 2. Issuer Name and Ticker or Trading SymbolNATIONAL SECURITY GROUP INC [NSEC] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__X__ Director _____ 10% Owner __X__ Officer (give title below) _____ Other (specify below) President/CEO |
(Last)
(First)
(Middle)
661 EAST DAVIS | 3. Statement for Issuer's Fiscal Year Ended (MM/DD/YYYY) 12/31/2019 |
(Street)
ELBA, AL 36323
(City)
(State)
(Zip)
| 4. If Amendment, Date Original Filed(MM/DD/YYYY) | 6. Individual or Joint/Group Filing(Check Applicable Line)
_X_ Form Filed by One Reporting Person
___ 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) | 2. Trans. Date | 2A. Deemed Execution Date, if any | 3. Trans. Code (Instr. 8) | 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) |
Amount | (A) or (D) | Price |
Common Stock | | | | | | | 10869 | D | |
Common Stock | | | | | | | 4087 | I | By 401-K Plan |
Common Stock | | | | | | | 6526.81 | I | By ESOP (1) |
Common Stock | | | | | | | 57713 | I | By Jerry B. Brunson Marital Trust/Jerry B. Brunson Family Trust (2) |
Common Stock | | | | | | | 366445 | I | By Brunson Properties, a General Partnership (3) |
Table II - Derivative Securities Acquired, Disposed of, or 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 (MM/DD/YYYY) | 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 at End of Issuer's Fiscal Year (Instr. 4) | 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) |
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
(1) | Between January 1, 2019 and February 28, 2019, the reporting person acquired 1,111.17 shares of NSEC common stock under the National Security ESOP. The information in this report is based on a plan statement received March 18, 2019. |
(2) | William L. Brunson, Jr. is co-trustee of the Jerry B. Brunson Marital and Jerry B. Brunson Family Trusts. The Reporting Person disclaims beneficial ownership associated with these shares. |
(3) | William L. Brunson, Jr. is Managing Partner of Brunson Properties. |
Reporting Owners
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Reporting Owner Name / Address | Relationships |
Director | 10% Owner | Officer | Other |
BRUNSON WILLIAM L JR 661 EAST DAVIS ELBA, AL 36323 | X |
| President/CEO |
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Signatures
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Brian R. McLeod, Attorney-in-fact | | 2/14/2020 |
**Signature of Reporting Person | Date |
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