UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
SYMONS INTERNATIONAL GROUP, INC.
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP:
( ) Check this box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See Instructions 1 (b).
1. Name and Address of Reporting
Symons, Douglas H.
7436 Glenvista Place
Fishers, Indiana 46038
USA
2. Issuer Name and Ticker or Trading Symbol
Symons International Group, Inc.
SIGC
3. IRS or Social Security Number of Reporting Person (Voluntary)
###-##-####
4. Statement for Month/Year
11/00
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person (s) to Issuer (Check all applicable)
(X) Director ( ) 10% Owner (X) Officer (give title below)
( ) Other (Specify Below)
Chief Executive Officer
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>
<CAPTION>
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<S> <C> <C> <C> <C> <C>
1. Title of 2. 4. Securities acquired (A) or 5. Amount of Securities 6. Direct 7. Nature of
Security 3. Disposed of (D) Benefically Owned at End of (D) or Indirect
Transactions Month Indirect (I) Beneficial
Ownership
Date Code V Amount A/D Price
Common 11/15/00 P 500 A .50 D
11/20/00 500 A .50 D
11/21/00 500 A .47 D
35,000
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Derivative 2. Conversion of Exercise 3. 5. Number of 6. Date Exercisable
Security Price of Derivative Security 4. Derivative and Expiration Date
Transaction Securities (Month/Day/Year)
Acquired (A) or
Disposed (D)
Date Code V Amount A/D Date Expiration
Exercisable Date
7. Title and Amount 8. Price of Derivative Security 9. Number of Derivative Securities
of Underlying Benefically Owned at End of Month
Securities
Title and Number
of Shares
</TABLE>
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Douglas H. Symons
