UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 3
SYMONS INTERNATIONAL GROUP, INC.
INITIAL STATEMENT OF BENEFICAL 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 (f) of the
Investment Company Act of 1940
1. Name and Address of Reporting Person
Earl R. Fonville
5296 Canary Ct.
Carmel, IN 46033
2. Date of Event Requiring Statement (Month/Day/Year)
9/18/00
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary)
4. Issuer Name and Tickler or Trading Symbol
Symons International Group, Inc.
SIGC
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
( ) Director (X) Officer (give title below) ( ) 10% Owner ( ) Other
Chief Financial Officer
6. If Amendment, Date of Original (Month/Day/Year)
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 Beneficially Owned
<S> <C> <C> <C>
1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect
Beneficially Owned Direct (D) or Indirect Beneficial Ownership
(I)
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5)
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of 2. Date 3. Title and 4. Conversion 5. Ownership 6. Nature of
Derivative Exercisable and Amount of or Exercise Form of Indirect
Security Expiration Date Securities Price of Derivative Beneficial
(Month/Day/ Underlying Derivative Securities: Ownership
Year) Derivative Security Direct (D) or
Security Indirect (I)
(Instr. 4) Date Exercisable Title (Instr. 5) (Instr. 5)
Expiration Date Amount or
Number of Shares
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Explanation of Responses:
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Signature of Reporting Person Date
