<PAGE> OMB Number 3235-0287
Expires: December 31, 2001
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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).
U.S. 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
(Print or Type Responses)
1. Name and Address of Reporting Person*
<< Edward W. LeBaron, Jr. >>
______________________________________________________________________
(Last) (First) (Middle), (Street), (City) (State) (Zip)
<< 2601 Fair Oaks Blvd., Sacramento, CA 95864 >>
2. Issuer Name and Ticker or Trading Symbol
<< Provident American Corporation (PAMC) >>
3. IRS or Social Security Number of Reporting Person (Voluntary) ________
4. Statement for Month/Year
<< 11-99 >>
5. If Amendment, Date of Original (Month/Year) ___________
6. Relationship of reporting person to issuer
(Check all applicable)
XX Director ____ 10% Owner
___ Officer (give ____ Other (specify
title below) below)
7. Individual or Joint/Group Filing (Check Applicable line)
XXXX Form filed by one Reporting Person
____ Form filed by More than One Reporting Person
<PAGE>
FORM 4 (continued) Page 2 of 5 Pages
1. Title of Security (Instr. 3)
<< Common Stock >>
2. Transaction Date (Month/Day/Year)
<< 11-3-99 >>
3. Transaction Code (Instr. 8)
Code V
<< J (1) __________ >>
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
Amount (A) or (D) Price
<< 28,571 A N/A >>
5. Amount of Securities Beneficially Owned at End of Month
(Inst. 3 and 4)
<< 33,571 >>
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
<< D >>
7. Nature of Indirect Beneficial Ownership (Inst. 4) __________
<PAGE>
FORM 4 (continued) Page 3 of 5 Pages
1. Title of Security (Instr. 3)
<< Common Stock >>
2. Transaction Date (Month/Day/Year)
<< 11-3-99 >>
3. Transaction Code (Instr. 8)
Code V
<< J(1) __________ >>
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5)
Amount (A) or (D) Price
<< 250,000 D N/A >>
5. Amount of Securities Beneficially Owned at End of Month
(Inst. 3 and 4)
<< See above >>
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
<< I >>
7. Nature of Indirect Beneficial Ownership (Inst. 4)
<< As member of limited liability company >>
___________________________________________________________________________
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)
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 control number.
SEC 1474 (3-99)
<PAGE>
FORM 4 (continued) Page 4 of 5 Pages
Table II - Derivative Securities Acquired, Disposed of,
or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible
securities)
1. Title of Derivative Security (Instr. 3)
___________________________
2. Conversion or Exercise Price of Derivative Security
___________________________
3. Transaction Date (Month/Day/Year)
___________________________
4. Transaction Code (Instr. 8)
Code V
____ ____________
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
(A) _______ (D) ______________
6. Date Exercisable and Expiration Date (Month/Day/Year)
Date Exercisable Expiration Date
__________ __________
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
Title Amount or Number of Shares
_________ ________________
8. Price of Derivative Security (Instr. 5)
____________
<PAGE>
FORM 4 (continued) Page 5 of 5 Pages
9. Number of derivative Securities Beneficially Owned at End of Month
(Instr. 4)
_________________
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
________________
11. Nature of Indirect Beneficial Ownership (Inst. 4)
Explanation of Responses: Edward E. LeBaron, Jr. 12/7/99
** Signature of Reporting Person
(1) J - A Limited liability company of which the reporting person was or
is a member distributed to the reporting person the shares described above.
These distributions to persons other than the reporting person also caused
the reduction in beneficial ownership described above.
** 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
CJR\4450\012\1074337.01
