U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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
[_] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
________________________________________________________________________________
1. Name and Address of Reporting Person*
Nelson John P.
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
11516 Miracle Hills Drive, Suite 102
- --------------------------------------------------------------------------------
(Street)
Omaha NE 68154
- --------------------------------------------------------------------------------
(City) (State) (Zip)
________________________________________________________________________________
2. Issuer Name and Ticker or Trading Symbol
Acceptance Insurance Companies Inc. (AIF)
________________________________________________________________________________
3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
________________________________________________________________________________
4. Statement for Month/Year
________________________________________________________________________________
5. If Amendment, Date of Original (Month/Year)
February 2000
================================================================================
6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
________________________________________________________________________________
7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[_] Form filed by more than one Reporting Person
________________________________________________________________________________
<PAGE>
================================================================================
Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
================================================================================
<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 487,178.3681(1)
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
(1) This Form 4 amends the Form 4 filed on February 10, 2000 and the Forms 3
and 4 previously filed to correct the reported amount of securities
beneficially owned by Mr. Nelson. Due to a series of inadvertent
mathematical and ministerial mistakes, the number of shares beneficially
owned by Mr. Nelson have been incorrectly reported on Forms 4. See the
attachment for a description of these amendments.
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
====================================================================================================================================
</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
<PAGE>
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
================================================================================
<TABLE>
<CAPTION>
10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock Options
(Right to Buy) Common 250,000 0 (2)
Stock
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
(2) These options expired in March 2000 pursuant to Mr. Nelson's agreement with
the Issuer.
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
====================================================================================================================================
</TABLE>
Explanation of Responses:
Name and address of Reporting Person: John P. Nelson, 11516 Miracle
Hills Drive, Suite 102, Omaha, NE 68154
Issuer Name and Ticker or Trading Symbol: Acceptance Insurance
Companies Inc. (AIF)
If Amendment, Date of Original (Month/Year): January 2000
Explanation of Responses to Amendment to Form 4 of Mr. John P. Nelson
filed February 10, 2000 (continued)
1. The Form 4 for December 1993 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) for Mr. Nelson as 874,133 shares. The correct
number of shares at that time was 792,245 shares. The Form 4
for December 1993 reported that Mr. Nelson held an
irrevocable proxy to vote 414,105 shares. The correct number
of shares subject to this proxy at that time was 332,217
shares. The total number of shares reported in the December
1993 Form 4 is hereby amended to correct this inadvertent
error.
2. The Form 4 for January 1997 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) by two companies established for Mr. Nelson's
daughters as 27,200 and 52,200 shares, respectively. The
correct number of shares owned by each company at that time
was 25,000 shares. The number of shares reported in the
January 1997 Form 4 is hereby amended to correct this
inadvertent error.
3. The Form 4 for February 1997 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) by two companies established for Mr. Nelson's
daughters as 77,200 and 102,200 shares, respectively. The
correct number of shares owned by each company at that time
was 50,000 shares. The number of shares reported in the
February 1997 Form 4 is hereby amended to correct this
inadvertent error.
4. On July 20, 1998, one of Mr. Nelson's daughters transferred
3,700 shares she owned to a trust established for her.
Immediately prior to this transfer, Mr. Nelson did not
beneficially own these shares. Mr. Nelson is a trustee of
this trust. The Forms 4 filed after July 20, 1998 are hereby
amended to include these 3,700 shares as beneficially
owned by Mr. Nelson indirectly.
5. The Form 4 for December 1998 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) by Mr. Nelson directly as 240,148 shares. The
correct number of shares owned by him directly at that time
was 200,216 shares. The number of shares reported in the
December 1998 Form 4 is hereby amended to correct this
inadvertent error.
6. The Form 4 for December 1999 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) for Mr. Nelson as 967,800 shares. The correct
number of shares at that time was 812,310 shares. This
discrepancy is attributable to a series of administrative and
mathematical errors. The total number of shares reported in
the December 1999 Form 4 is hereby amended to correct this
inadvertent error.
7. The Form 4 for January 2000 incorrectly reported the Amount
of Securities Beneficially Owned at End of Month (Table I,
column 5) for Mr. Nelson as 483,467 shares. The correct
number of shares at that time was 487,178.3681 shares. This
revised number includes the 3,700 shares held in a trust
established for one of Mr. Nelson's daughters as set forth in
4 above and 12.3681 shares held in the Issuer's Employee
Stock Ownership and Tax Deferred Savings Plan instead of the
one share included in the number of shares previously
reported. The total number of shares reported in the January
2000 Form 4 is hereby amended to correct this inadvertent
error.
/s/ John P. Nelson 05/02/00
--------------------------------------------- ---------------------
**Signature of Reporting Person Date
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
