SEC FORM
4
SEC Form 4
| FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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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| OMB Number: |
3235-0287 |
| Estimated average burden |
| hours per response: |
0.5 |
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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). |
1. Name and Address of Reporting Person*
(Street)
| SALT LAKE CITY |
UT |
84157-0220 |
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2. Issuer Name and Ticker or Trading Symbol
SECURITY NATIONAL FINANCIAL CORP
[ SNFCA ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
| X |
Officer (give title below) |
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Other (specify below) |
| V.P., Treasurer, CFO |
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3. Date of Earliest Transaction
(Month/Day/Year)
12/23/2004
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
| X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|---|
| 1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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| Code |
V |
Amount |
(A) or (D) |
Price |
| Class A Common Stock |
12/23/2004 |
|
M |
|
3,718 |
A |
$5.9
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20,634 |
D |
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| Class A Common Stock |
01/22/2005 |
|
J
|
|
1,032 |
A |
$0
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21,666
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D |
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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)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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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 |
| Employee Stock Option (right to buy) |
$5.9
|
12/23/2004 |
|
M |
|
|
3,718 |
03/21/2003 |
03/21/2013 |
Class A Common Stock |
3,718 |
$0
|
0 |
D |
|
| Employee Stock Option (right to buy) |
$3.23
|
12/10/2004 |
|
A |
|
5,000 |
|
12/10/2004 |
12/10/2014 |
Class A Common Stock |
5,000 |
$0
|
5,000
|
D |
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| Explanation of Responses: |
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|
/s/Stephen M. Sill |
03/31/2005 |
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** 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. |
EXHIBIT 99
Stephen M. Sill
---------------
1/ Received pursuant to a 5% stock dividend paid on January 22, 2005.
2/ Owned jointly by the reporting person and his wife, Vorelle P. Sill.
Does not include 31,172 shares of Class A Common Stock owned indirectly
by the reporting person, including (A) 22,126 shares of Class A Common
Stock acquired pursuant to the Security National Financial Corporation
Tax-Favored Retirement Savings Plan 401(k) Plan and allocated to the
reporting person's account (including 768 shares of Class A Common
Stock the reporting person acquired under the 401(k) Plan between April
1, 2004 and December 31, 2004, and 1,054 shares of Class A Common Stock
that were allocated to the reporting person's account on January 22,
2005 pursuant to a 5% stock dividend declared on December 10, 2004), of
which the reporting person disclaims voting and investment powers with
respect to such shares; (B) 3,648 shares of Class A Common Stock
acquired under the Security National Financial Corporation Employee
Stock Ownership Plan (ESOP), in reliance on old Rule 16a-8(g)(3)
(including 174 shares of Class A Common Stock that were allocated to
the reporting person's account on January 22, 2005 pursuant to a 5%
stock dividend declared on December 10, 2004), of which the reporting
person disclaims voting and investment powers with respect to such
shares; and (C) 5,398 shares of Class A Common Stock acquired under the
Deferred Compensation Plan (including 3,172 shares of Class A Common
Stock the reporting person acquired under the Deferred Compensation
Plan between April 1, 2004 and December 31, 2004, and 257 shares of
Class A Common Stock that were allocated to the reporting person's
account on January 22, 2005 pursuant to a 5% stock dividend on December
10, 2004), of which the reporting person disclaims voting and
investment powers with respect to such shares. The reporting person
disclaims beneficial ownership of the reported securities except to the
extent of his pecuniary interest therein.
3/ Grant to reporting person of options to purchase 5,000 shares of Class
A Common Stock under the Security National Financial Corporation 2003
Stock Option Plan. The options became exercisable on December 10, 2004.
