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FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
___ Check this box if
no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
to Section 16.
Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities Exchange
obligations may Act of 1934, Section 17(a) of the Public Utility Holding
continue. See Company Act of 1935 or Section 30(f) of the Investment
Instruction 1(b). Company Act of 1940
1. Name and Address of Reporting Person 2. Issuer Name and Ticker or 6. Relationship of Reporting Person to
Trading Symbol Issuer
(Check all applicable)
Siebert Raymond N. Acceptance Insurance
(Last) (First) (Middle) Companies Inc. (AIF) ___ Director ___ 10% Owner
_X_ Officer (give ___ Other (specify
3. IRS or Social 4. Statement for title below)
Security Month/Year below)
Number of
222 South 15th Street, Suite 600 North Reporting 7/96 Vice President, Administration
(Street) Person
(Voluntary) 5. If Amendment,
Date of Original
(Month/Year)
Omaha NE 68102
(City) (State) (Zip)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action action or Disposed of (D) Securities ship Indirect
Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial
(Month/ (Instr. -------------------------- Owned at End Direct Ownership
Day/ 8) (A) of Month (D) or (Instr. 4)
Year) ---------- or (Instr. 3 Indirect
Code V Amount (D) Price and 4) (I)
(Instr. 4)
- -------------------- ---------- ---- ---- ---------- --- --------- --------------- ------------- ------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly
(Print or Type Responses)
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FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security 2. Conversion 3. Transaction 4. Transaction 5. Number of Derivative
(Instr. 3) or Exercise Date Code Securities Acquired
Price of (Month/Day/ (Instr. 8) (A) or Disposed of (D)
Derivative Year) (Instr. 3, 4, and 5)
Security -------------- -------------------------
Code V (A) (D)
- ----------------------------------------- -------------- -------------- ------ ----- ----------- -----------
<S> <C> <C> <C> <C> <C> <C>
Incentive Stock Option * 7/1/96 A V 15,000
6. Date Exercisable 7. Title and Amount of Under- 8. Price of 9. Number of 10. Ownership 11. Nature of
and Expiration lying Securities Derivative Derivative Form of Indirect
Date (Instr. 3 and 4) Security Securities Derivative Beneficial
(Month/Day/Year) (Instr. 5) Beneficially Security: Ownership
- ---------------------- ----------------------------- Owned at End Direct (D) (Instr. 4)
Date Expira- Amount or of Month or Indirect
Exer- tion Title Number of (Instr. 4) (I)
cisable Date Shares (Instr. 4)
- ---------- ---------- ---------------- ----------- ------------- --------------- ---------------- --------------
<C> <C> <C> <C> <C> <C> <C> <C>
* 7/1/06 Common Stock 15,000 N/A 15,000 D
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Explanation of Responses:
*The option was granted pursuant to Acceptance Insurance Companies
Inc.'s 1996 Incentive Stock Option Plan and becomes exercisable
in five equal installments beginning one year following the date
of the grant. The exercise prices for the five installments are
$17.125, $19.694, $22.648, $26.045, $29.952 and $34.445, respectively.
**Intentional misstatements or omissions of facts constitute /s/ Raymond N. Siebert 8/8/96
Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. --------------------------------------------
78ff(a). **Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be
manually signed. If space provided is insufficient, see
Instruction 6 for procedure.
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