ATLANTIC AMERICAN CORPORATION/HARRIETT J. ROBINSON
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

FORM 4

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
Section 17(a) of the Public Utility Holding Company Act of 1935
or Section 30(h) of the Investment Company Act of 1940

o Check this box if no longer
subject to Section 16.
Form 4 or Form 5
obligations may continue.
See Instruction 1(b).

1. Name and Address of Reporting
Person*
2. Issuer Name and Ticker or Trading
Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Robinson, Harriet J.
(Last) (First) (Middle)
  Atlantic American Corporation -- AAME
 
     
  3500 Tuxedo Road, NW

(Street)
4. Statement for Month/Day/Year 5. If Amendment, Date of Original (Month/Day/Year)
    January 28, 2003
 
     
    6. Relationship of Reporting Person(s)
to Issuer
(Check All Applicable)
7. Individual or Joint/Group Filing
(Check Applicable Line)
  Atlanta, GA 30305-1068
(City)        (State)        (Zip)
  x  Director x  10% Owner   x Form Filed by One Reporting Person
    o  Officer (give title below)   o Form Filed by More than One Reporting Person
    x  Other (specify below)

   Trustee under Rule 16a-8   
 
             

Reminder:   Report on a separate line for each class of securities beneficially owned directly or indirectly.
 
*   If the form is filed by more than one reporting person, see instruction 4(b)(v).


 

                                               

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 3)
2. Transaction
Date

(Month/Day/Year)
2A. Deemed Execution
Date, if any

(Month/Day/Year)
3. Transaction
Code

(Instr. 8)
4. Securities Acquired (A) or
Disposed of (D)

(Instr. 3, 4 and 5)
5. Amount of Sec-
urities Beneficially
Owned Following
Reported Trans-
action(s)

(Instr. 3 and 4)
6. Ownership
Form:
Direct (D) or
Indirect (I)

(Instr. 4)
7. Nature of
Indirect
Beneficial
Ownership

(Instr. 4)

              Code V   Amount (A)
or
(D)
Price          

  Common Stock                   8,929     I   401(k) Plan by Spouse(1)***

  Common Stock   N/A                 6,720     I   Joint w/grandson

  Common Stock   N/A                 1,971,623     I   (2)***

  Common Stock   N/A                 3,411,102     I   By Gulf Capital Services(3)

  Common Stock   N/A                 3,953,256     I   (4)***

  Common Stock   N/A                 4,026,992     I   (5)***

  Common Stock   01/28/03     P     2,000   A   $1.50           D  

  Common Stock   01/29/03     P     300   A   $1.54     425,312     D  

                         

                         

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Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
  (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative
Security

(Instr. 3)
2. Conversion or Exercise
Price of Derivative
Security
3. Transaction
Date

(Month/Day/Year)
3A.  Deemed Execution
Date, if any

(Month/Day/Year)
4. Transaction
Code

(Instr. 8)
5. Number of Derivative Securities
Acquired (A) or Disposed of (D)

(Instr. 3, 4 and 5)

                      Code V   (A) (D)

  Employee Stock Option (6)         N/A      

  Option to Buy (7)         N/A      

               

               

               

               

               

               

               

               

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Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

    Cmn.Stk.           100,000     I   By Spouse

    Cmn. Stk.           5,000     D  

                   

                   

                   

                   

                   

                   

                   

                   

Explanation of Responses:

***Reporting Person expressly disclaims beneficial ownership of such securities.

(1) Information herein is based on a plan statement as of December 31, 2001.

(2) Includes 740,921 shares held directly by spouse; 936,702 shares held by Delta Life Ins. Co.; and 294,000 shares held by Delta Fire & Casualty Ins. Co.

(3) Spouse individually holds a 24% interest in the Partnership. The remaining partnerships are held in equal shares by Trust for benefit of the reporting person's daughters, with the reporting person as Trustee.

(4) By self as Trustee for Robin Robinson, securities held directly by Trust.

(5) By self as Trustee for Jill Robinson, securities held directly by Trust.

(6) Option to buy Common Stock, granted at an option price of $3.374 per share under the Atlantic American Corporation 1992 Incentive Plan.

(7) Granted pursuant to the Company’s 1996 Director Stock Option Plan at option prices ranging from $1.90 to $4.4375.

/s/ Harriet J. Robinson   01/30/03

**Signature of Reporting Person
 
Date


**   Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
 
Note:   File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.

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