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OMB APPROVAL
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OMB Number: 3235-0287
Expires: September 30, 1998
Estimated average burden
hours per response ....0.5
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FORM 4
/ / Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See instruction 1(b).
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, 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*
Heitz, Mark V.
AmVestors Financial Corporation
One AmVestors Place
555 S. Kansas Avenue
Topeka, KS 66601-2039
USA
2. Issuer Name and Ticker or Trading Symbol
AmerUs Life Holdings, Inc. (AMH)
3. IRS or Social Security Number of Reporting Person (voluntary)
4. Statement for Month/Year
9/1998
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
/ / Director / / 10% Owner
/X/ Officer (give title below) / / Other (specify below)
President & CEO - AmVestors Financial Corporation
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7. Individual or Joint/Group Filing (Check Applicable Line)
/X/ Form filed by One Reporting Person
/ / Form filed by More than One Reporting Person
<TABLE>
Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<CAPTION>
1. Title of Security 2. Trans- 3. Trans- 4. Securities 5. Amount 6. Ownership 7. Nature of
(Instr. 3) action action Acquired(A) of Sec- Form Indirect
Date Code or Disposed urities Direct (D) Beneficial
(Month/ (Instr. of (D) Benefici- or Indirect Ownership
Day/Year) 8) (Instr. 3, 4, ally (I) (Instr. 4)
and 5) Owned at (Instr. 4)
End of
Month
(Instr.
3 and 4)
---- --- ------ ------- ------
Code V Amount (A) or Price
(D)
------------------- ------ ---- --- ------ ------- ------ ------- ----------- -----------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Class A Common Stock 9/8/1998 P V 100.00 A 25.50 41,407.00 D
Class A Common Stock 7,601.44(1) I ESOP Trust (2)
</TABLE>
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).
<PAGE>
<TABLE>
Form 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<CAPTION>
1. Title of 2. Conversion 3. Transaction 4. Transaction 5. Number of 6. Date
Derivative or Exercise Date Code Derivative Exercisable
Security Price of (Month/ (Instr. 8) Securities and
(Instr. 3) Derivative Day/Year) Acquired (A) Expiration
Security or Disposed Date
of (D) (Month/
(Instr. 3, 4, Day/Year)
and 5)
---- ---- ----- ---- ------ -----
Code V (A) (D) Date Expir-
Exer- ation
cisable Date
------------------- ------------ ------------ ---- ---- ----- ---- ------ -----
<S> <C> <C> <C> <C> <C> <C> <C> <C>
</TABLE>
<PAGE>
<TABLE>
Table II (continued)
1. Title of 7. Title and Amount 8. Price of 9. Number of 10. Ownership 11. Nature of
Derivative Underlying Derivative Derivative Form of Indirect
Security Securities Security Securities Derivative Beneficial
(Instr. 3) (Instr. 3 and 4) (Instr. 5) Beneficially Security: Ownership
Owned at End Direct (D) (Instr. 4)
of Month or Indirect
(Instr. 4) (I)
(Instr. 4)
------ ----------
Title Amount or
Number of
Shares
------------ ------ ---------- ------------ ------------ ------------ ------------
<S> <C> <C> <C> <C> <C> <C>
</TABLE>
<PAGE>
Explanation of Responses:
1. Mr. Heitz's 12/31/97 Form 5 filing reported 7,600.51 shares held indirectly
through the ESOP Trust at 12/31/97. However, at the time the Form 5 was
filed, the last available statement of account did not show the final
amount held in the ESOP Trust as of 12/31/97. Subsequent to March 1, 1998,
final accounting entries were made and a revised year-end 1997 statement
was issued showing actual total shares held indirectly by Mr. Heitz through
the ESOP Trust were 7,601.439 shares.
2. Employee Stock Ownership Plan Trust
** 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.
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB Number.
/s/ Mark V. Heitz September 17, 1998
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**Signature of Reporting Person Date