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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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 control number. | SEC 1474 (9-02) |
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 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) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MAGNOLIA CAPITAL PARTNERS, LLC 15 E. 5TH STREET, SUITE 3200 TULSA, OK 74103 |
X | |||
Heyman Stephen J 15 EAST 5TH STREET, SUITE 3200 TULSA, OK 74103 |
X | |||
Adelson James F 15 EAST 5TH STREET, SUITE 3200 TULSA, OK 74103 |
X |
Stephen J. Heyman | 02/14/2013 | |
**Signature of Reporting Person | Date | |
James F. Adelson | 02/14/2013 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Reflects a reverse stock split of common stock effective January 29, 2013 whereby every three of Atlas Financial Holdings, Inc.'s issued and outstanding common stock were automatically combined into one share of common stock. |
Remarks: This is a joint filing with Magnolia Capital Partners, LLC as the designated filer. Also included in this filing are Stephen J. Heyman and James F. Adelson. Messrs. Heyman and Adelson are the sole managers of Magnolia Capital Partners, LLC. Messrs. Heyman and Adelson disclaim beneficial ownership of the reported securities except to the extent of their pecuniary interest therein. |