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 APPROVAL |
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)
X |
Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
Pres., Chief Operating Officer |
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3. Date of Earliest Transaction
(Month/Day/Year) 01/22/2005
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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 |
01/22/2005 |
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J
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8,451 |
A |
$0
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177,472
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D |
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Class A Common Stock |
01/22/2005 |
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J
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2,285 |
A |
$0
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47,993
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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
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03/21/2003 |
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A |
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70,000 |
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03/21/2003 |
03/21/2013 |
Class A Common Stock |
70,000 |
$0
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70,000
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D |
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Employee Stock Option (right to buy) |
$0.36
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07/16/2004 |
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A |
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500,000 |
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07/16/2004 |
07/16/2014 |
Class C Common Stock |
500,000 |
$0
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500,000
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D |
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Employee Stock Option (right to buy) |
$0.323
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12/10/2004 |
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A |
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500,000 |
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12/10/2004 |
12/10/2014 |
Class C Common Stock |
500,000 |
$0
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500,000
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D |
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Explanation of Responses: |
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/s/Scott M. Quist |
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
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Scott M. Quist
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1/ Received pursuant to a 5% stock dividend paid on January 22, 2005.
2/ Owned jointly by the reporting person and his wife, Lisa Quist. Does
not include 93,237 shares of Class A Common Stock and 209,086 shares of
Class C Common Stock owned indirectly by the reporting person,
including (A) 14,745 shares of Class A Common Stock and 18,386 shares
of Class C Common Stock held by Associated Investors, a Utah general
partnership (including 702 shares of Class A Common Stock and 876
shares of Class C Common Stock that were allocated to the reporting
persons partner's account in Associated Investors on January 22, 2005
pursuant to a 5% stock dividend declared on December 10, 2004), of
which the reporting person disclaims voting and investment and
investment powers with respect to such shares; (B) 27,624 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 2,063 shares
of Class A Common Stock the reporting person acquired under the 401(k)
Plan between April 1, 2004 and December 31, 2004, and 1,315 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; (C) 20,289 shares of
Class A Common Stock and 190,700 shares of Class C Common Stock
acquired under the Employee Stock Ownership Plan (ESOP), in reliance on
old Rule 16a-8(g)(3) (including 966 shares of Class A Common Stock and
9,081 shares of Class C 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
(D) 30,579 shares of Class A Common Stock acquired under the Security
National Financial Corporation Deferred Compensation Plan (including
6,553 shares of Class A Common Stock the reporting person acquired
under the Deferred Compensation Plan between April l, 2004 and December
31, 2004, and 1,456 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 70,000 shares of Class
A Common Stock under the Security National Financial Corporation 1993
Stock Option Plan. The options became exercisable on March 21, 2003,
but any shares of Class A Common Stock acquired from the exercise of
the options shall be forfeited if the reporting person does not remain
employed by the Company for the later of (i) five years following the
date of grant, or March 21, 2008, or (ii) two years following the date
these options have been exercised by the reporting person.
4/ Grant to reporting person of options to purchase 500,000 shares of
Class C Common Stock under the Security National Financial Corporation
2003 Stock Option Plan. The options became exercisable on July 16,
2004. Pursuant to the Company's Amended Articles of Restatement of the
Articles of Incorporation, each ten shares of Class C Common Stock may
at any time be converted into one share of Class A Common Stock. The
Class A Common Stock is publicly traded on the Nasdaq Stock Market but
the Class C Common Stock is not publicly traded. Accordingly, the
exercise price of the options to purchase Class C Common stock is
one-tenth (1/10) of the closing sale price of the Class A Common Stock
on the date such options are exercised. The closing sale price of the
Class A Common Stock was $3.60 per share on July 16, 2004.
5/ Grant to reporting person of options to purchase 500,000 shares of
Class C Common Stock under the Security National Financial Corporation
2003 Stock Option Plan. The options became exercisable on December 10,
2004. Pursuant to the Company's Amended Articles of Restatement of the
Articles of Incorporation, each ten shares of Class C Common Stock may
at any time be converted into one share of Class A Common Stock. The
Class A Common Stock is publicly traded on the Nasdaq Stock Market but
the Class C Common Stock is not publicly traded. Accordingly, the
exercise price of the options to purchase Class C Common stock is
one-tenth (1/10) of the closing sale price of the Class A Common Stock
on the date such options are exercised. The closing sale price of the
Class A Common Stock was $3.23 per share on December 10, 2004.