UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM 5
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
( ) Check box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See Instructions 1(b).
( ) Form 3 Holdings Reported
( ) Form 4 Transactions Reported
1. Name and Address of Reporting Person
Gongaware, Donald F.
11825 N. Pennsylvania Street
Carmel, IN 46032
USA
2. Issuer Name and Ticker or Trading Symbol
Conseco, Inc.
CNC
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
December 31, 1997
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)
Executive Vice President and Chief Operations Officer
7. Individual or Joint/Group Reporting (Check Applicable Line)
(X) Form filed by One Reporting Person
( ) Form filed by More than One Reporting Person
<TABLE>
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Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect |
|Transaction| or Disposed of (D) | Securities |ect | Beneficial Ownership |
|Date |Code| | Beneficially |(D)or | |
| | | | A/| | Owned at |Indir | |
| | | Amount | D | Price | End of Year |ect(I)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock | | | | | |2,677,099 |D | |
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Common Stock | | | | | |62,000(1) |I |By Wife |
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Common Stock | | | | | |280,000 |I |By Trust |
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Common Stock | | | | | |126,000 |I |By Trust |
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Common Stock | | | | | |1,293 |I |By 401(k) Plan |
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Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned |
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1.Title of Derivative |2.Con |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of|
Security |version |Transaction rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect |
|or Exer |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial |
|cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership |
|ice of | | | posed of(D) |Day/Year) | |rity |Benefi |or | |
|Deriva | | | |Date |Expir| | |ficially |Ind| |
|tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| |
|Secu | | | | D |cisa-|Date | of Shares | |End of |ct | |
|rity | | | Amount | |ble | | | |Year |(I)| |
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Options to Purchase (2) | | | | | | | | | | |2,122,824 |D | |
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Stock Units (3) |-0- |3/31/|A |23,638.3 |A |(3) |(3) |Common Stock|23,638.| | |D | |
| |97 | | | | | | |3 | | | | |
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Stock Units (3) |-0- |4/1/9|A |79.7 |A |(3) |(3) |Common Stock|79.7 | | |D | |
| |7 | | | | | | | | | | | |
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Stock Units (3) |-0- |7/1/9|A |81.1 |A |(3) |(3) |Common Stock|81.1 | | |D | |
| |7 | | | | | | | | | | | |
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Stock Units (3) |-0- |10/1/|A |240.2 |A |(3) |(3) |Common Stock|240.2 | | |D | |
| |97 | | | | | | | | | | | |
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Stock Units (3) |-0- |1/2/9|A |259.6 |A |(3) |(3) |Common Stock|259.6 | |94,224.5 |D | |
| |8 | | | | | | | | | | | |
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Stock Units (4) | | | | | | | | | | |382,582 |D | |
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Explanation of Responses:
(1) The reporting person disclaims beneficial ownership of these securities,
and this report shall not be deemed
an admission that the reporting person is the beneficial owner of such
securities for purposes of Section 16 or
for any other purpose.
(2) Represents stock options held by the Reporting Person as previously
reported.
(3) Granted under the Conseco, Inc. 1994 Stock and Incentive
Plan.
(4) Represents common stock units conditionally awarded under the Issuer's
Executive Deferred Compensation
Program as previously
reported.
SIGNATURE OF REPORTING PERSON
/s/Donald F. Gongaware by Karl W. Kindig, Attorney-in-Fact