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U.S. 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(f) of the Investment Company Act of 1940
[ ] Check this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
West Mark C.
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(Last) (First) (Middle)
1100 Circle 75 Parkway, Suite 760
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(Street)
Atlanta GA 30339-3097
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Atlantic American Corporation - AAME
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3. IRS or Social Security Number of Reporting Person (Voluntary)
###-##-####
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4. Statement for Month/Year
September, 1999
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ X ] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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7. 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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6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock (1***) N/A 66,142 I
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Common Stock (2***) N/A 5,000 I
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Common Stock (3) 9/9/99 P 2,500 A $3.50 I
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Common Stock (3) 9/13/99 P 2,000 A $3.50 I
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Common Stock (3) 9/16/99 P 1,000 A $2.75 I
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Common Stock (3) 9/29/99 P 14,000 A $2.75 I
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Common Stock (3) 9/29/99 P 5,000 A $2.75 I
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Common Stock (3) 9/30/99 P 10,000 A $2.50 99,500 I
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* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Page 1 of 2
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially
Owned (e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Option to Buy(4) N/A Common 7,000 D
Stock
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Explanation of Responses:
(1) Shares owned by The West Foundation, Inc. for which Mr. West is an officer,
and disclaims any beneficial ownership of the foundation.
(2) Shares owned by the George West Mental Health Foundation, for which Mr.
West is the President.
*** Mr. West disclaims any beneficial ownership of these foundations.
(3) Shares contributed to Atlantis Capital LLLP, for which Mr. West is the
President of the General Partner (Genoa Realty Services, Inc.)
(4) Granted pursuant to the Company's 1996 Director Stock Option Plan at option
prices ranging from $3.00 to $4.4375.
/s/ 10/6/99
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**Signature of Reporting Person Date
* Beneficial ownership disclaimed except to extent of percuniary interest.
** 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 provided is insufficient, see Instruction 6 for procedures.
Alternatively, this Form is permitted to be submitted to the Commission
in electronic format at the option of the reporting person pursuant to
rule 101(b)(4) of Regulation S-T.
Page 2 of 2
(122797DTI)