SEC Form 5
FORM 5 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol UTG INC [ UTGN ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 12/31/2019 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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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. 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 Securities Beneficially Owned at end of Issuer's Fiscal Year (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 | 54,827 | D | |||||||||||||
Common Stock | 01/01/2019 | G | 6,922 | D | $0 | 359,590 | I | By First Southern Funding, LLC(1)(2) | |||||||
Common Stock | 01/01/2019 | G | 6,922 | A | $0 | 359,590 | I | By First Southern Funding, LLC(1)(2) | |||||||
Common Stock | 04/10/2019 | G | 433 | D | $0 | 359,590 | I | By First Southern Funding, LLC(1)(3) | |||||||
Common Stock | 72,750 | I | By WCorrell, Limited Partnership(4) | ||||||||||||
Common Stock | 12/19/2019 | G | 299 | D | $0 | 204,909 | I | By First Southern Bancorp, Inc.(5)(6) | |||||||
Common Stock | 1,201,876 | I | By First Southern Holdings, LLC(7) |
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 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) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 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: 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. The reporting person is President and Manager of First Southern Funding, LLC. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
2. This transaction is being reported to reflect a gift of First Southern Funding, LLC membership interest by the reporting person to his spouse. On January 1, 2019, the reporting person gifted membership units to his spouse representing 2.00% of the total outstanding membership units in First Southern Funding, LLC. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
3. This transaction is being reported to reflect a gift of First Southern Funding, LLC membership interest by the reporting person. On April 10, 2019, the reporting person gifted membership units representing 0.12% of the total outstanding membership units in First Southern Funding, LLC. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
4. The reporting person is the managing general partner of WCorrell, Limited Partnership. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
5. The reporting person is Chairman and President of First Southern Bancorp, Inc. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
6. This transaction is being reported to reflect a gift of First Southern Bancorp, Inc. shares by the reporting person. The reporting person gifted 4,422 shares (0.15% of those outstanding) on December 19, 2019. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
7. The reporting person is the President and First Southern Bancorp, Inc. is a 99% member of First Southern Holdings, LLC. See note (5). The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
/s/ Jesse T. Correll | 02/12/2020 | |
** Signature of Reporting Person | Date | |
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). | ||
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |