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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 | ||||||||
Employee Stock Option (Right to Buy) | $ 60.3 | 11/15/2006 | 11/15/2006 | D | 10,000 | (1) | 02/10/2016 | Common Stock | 10,000 | $ 8.7 | 0 | D | |||
Employee Stock Option (Rigtht to Buy) | $ 57.4 | 11/15/2006 | 11/15/2006 | D | 10,000 | (1) | 09/06/2016 | Common Stock | 10,000 | $ 11.6 | 0 | D | |||
Performance Rights | $ 0 | 11/15/2006 | 11/15/2006 | D | 91.84 | (2) | (2) | Common Stock | 91.84 | $ 69 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Boltz Michael David 699 WALNUT STREET SUITE 2000 DES MOINES, IA 50309 |
EVP&Chief Information Officer |
/s/ Jeananne M. Celander, Attorney-in-fact for Mr. Boltz | 11/15/2006 | |
**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) | This option was vested immediately and was disposed of pursuant to the merger agreement between the issuer and Aviva plc for the price reflected in column 8. |
(2) | These performance units were vested immediately and were disposed of pursuant to the merger agreement between the issuer and Aviva plc for $69 per share on the effective date of the merger. |
Remarks: AmerUs Group Co. (NYSE: AMH) was merged into an acquisition subsidiary of Aviva plc on 11/15/2006. This form reports "disposition" of all AMH securities in the merger. |