<PAGE>
OMB APPROVAL
-----------------------------
OMB Number: 3235-0207
Expires: September 30, 1998
Estimated average burden
hours per response ...... 0.5
-----------------------------
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
[_] Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. See Instruction 1(b)
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
DeMotto Benjamin A.
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
11845 West Olympic Boulevard
- --------------------------------------------------------------------------------
(Street)
Los Angeles CA 90064
- --------------------------------------------------------------------------------
(City) (State) (Zip)
- --------------------------------------------------------------------------------
2. Issuer Name and Ticker or Trading Symbol
John Adams Life Corporation (JALC)
- --------------------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
- --------------------------------------------------------------------------------
4. Statement for Month/Year
8/97
- --------------------------------------------------------------------------------
5. If Amendment, Date of Original (Month/Year)
- --------------------------------------------------------------------------------
6. Relationship of Reporting Person to Issuer
(Check all applicable)
X Director X 10% Owner
----- ------
X Officer (give Other (Specify
----- title below) ------ below)
President and Chief Executive Officer
- --------------------------------------------------------------------------------
7. Individual or Joint/Group Filing (Check applicable line):
Form filed by One Reporting Person
-----
X Form filed by more than One Reporting Person
------
- --------------------------------------------------------------------------------
<TABLE>
<CAPTION>
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. Ownership 7. Nature
(Instr. 3) action action or Disposed (D) Securities Form: of Indirect
Date Code Beneficially Direct Beneficial
(Instr. 8) (Instr. 3, 4 and 5) Owned at (D) or Ownership
(Month/ ------------ -------------------------- End of Month Indirect (Instr. 4)
Day/ Code V Amount (A) or Price (Instr. 3 (I)
Year) (D) and 4) (Instr. 4)
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
/1/
Common Stock 8/27/97 P 175,000 $.625 1,555,000 I As co-trustee
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If this form is filed by more than one person, see instruction 4(b)(v).
______________________
/1/ Mr. DeMotto is the Co-trustee of the Benjamin A. DeMotto and Patricia L.
DeMotto Living Trust
SEC 1474 (7/96)
<PAGE>
FORM 4 (continued)
<TABLE>
<CAPTION>
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 6. Date Exercisable
(Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration
Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date
Derivative Year) (Instr. 3 and 4) (Month/Day/
Security Year)
--------------- -------------------------- -------------------
Code V (A) (D) Date Expiration
Exer- Date
cisable
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
</TABLE>
<TABLE>
<CAPTION>
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect
Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership
(Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4)
(Instr. 4) Indirect (I) (Instr. 4)
- ------------------------
Title Amount or
Number of
Shares
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
<S> <C> <C> <C> <C>
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
</TABLE>
Explanation of Responses:
SEC 1474 (7-96)
<PAGE>
OMB APPROVAL
-----------------------------
OMB Number: 3235-0207
Expires: September 30, 1998
Estimated average burden
hours per response ...... 0.5
-----------------------------
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
[_] Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. See Instruction 1(b)
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
DeMotto Patricia L.
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
11845 West Olympic Boulevard
- --------------------------------------------------------------------------------
(Street)
Los Angeles CA 90064
- --------------------------------------------------------------------------------
(City) (State) (Zip)
- --------------------------------------------------------------------------------
2. Issuer Name and Ticker or Trading Symbol
John Adams Life Corporation (JALC)
- --------------------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
- --------------------------------------------------------------------------------
4. Statement for Month/Year
8/97
- --------------------------------------------------------------------------------
5. If Amendment, Date of Original (Month/Year)
- --------------------------------------------------------------------------------
6. Relationship of Reporting Person to Issuer
(Check all applicable)
Director X 10% Owner
----- ------
Officer (give Other (Specify
----- title below) ------ below)
- --------------------------------------------------------------------------------
7. Individual or Joint/Group Filing (Check applicable line):
Form filed by One Reporting Person
-----
X Form filed by more than One Reporting Person
------
- --------------------------------------------------------------------------------
<TABLE>
<CAPTION>
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. Ownership 7. Nature
(Instr. 3) action action or Disposed (D) Securities Form: of Indirect
Date Code Beneficially Direct Beneficial
(Instr. 8) (Instr. 3, 4 and 5) Owned at (D) or Ownership
(Month/ ------------ -------------------------- End of Month Indirect (Instr. 4)
Day/ Code V Amount (A) or Price (Instr. 3 (I)
Year) (D) and 4) (Instr. 4)
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
/2/
Common Stock 8/27/97 P 175,000 $.625 1,555,000 I As co-trustee
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If this form is filed by more than one person, see instruction 4(b)(v).
______________________
/2/ Mrs. DeMotto is the Co-trustee of the Benjamin A. DeMotto and Patricia L.
DeMotto Living Trust
SEC 1474 (7/96)
<PAGE>
FORM 4 (continued)
<TABLE>
<CAPTION>
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 6. Date Exercisable
(Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration
Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date
Derivative Year) (Instr. 3 and 4) (Month/Day/
Security Year)
--------------- -------------------------- -------------------
Code V (A) (D) Date Expiration
Exer- Date
cisable
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
</TABLE>
<TABLE>
<CAPTION>
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect
Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership
(Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4)
(Instr. 4) Indirect (I) (Instr. 4)
- ------------------------
Title Amount or
Number of
Shares
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
<S> <C> <C> <C> <C>
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
</TABLE>
Explanation of Responses:
SEC 1474 (7-96)
<PAGE>
OMB APPROVAL
-----------------------------
OMB Number: 3235-0207
Expires: September 30, 1998
Estimated average burden
hours per response ...... 0.5
-----------------------------
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
[_] Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. See Instruction 1(b)
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
Benjamin A. DeMotto and Patricia L. DeMotto Living Trust
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
11845 West Olympic Boulevard
- --------------------------------------------------------------------------------
(Street)
Los Angeles CA 90064
- --------------------------------------------------------------------------------
(City) (State) (Zip)
- --------------------------------------------------------------------------------
2. Issuer Name and Ticker or Trading Symbol
John Adams Life Corporation (JALC)
- --------------------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
- --------------------------------------------------------------------------------
4. Statement for Month/Year
8/97
- --------------------------------------------------------------------------------
5. If Amendment, Date of Original (Month/Year)
- --------------------------------------------------------------------------------
6. Relationship of Reporting Person to Issuer
(Check all applicable)
X Director X 10% Owner
----- ------
X Officer (give Other (Specify
----- title below) ------ below)
President and Chief Executive Officer
- --------------------------------------------------------------------------------
7. Individual or Joint/Group Filing (Check applicable line):
Form filed by One Reporting Person
-----
X Form filed by more than One Reporting Person
------
- --------------------------------------------------------------------------------
<TABLE>
<CAPTION>
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. Ownership 7. Nature
(Instr. 3) action action or Disposed (D) Securities Form: of Indirect
Date Code Beneficially Direct Beneficial
(Instr. 8) (Instr. 3, 4 and 5) Owned at (D) or Ownership
(Month/ ------------ -------------------------- End of Month Indirect (Instr. 4)
Day/ Code V Amount (A) or Price (Instr. 3 (I)
Year) (D) and 4) (Instr. 4)
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 8/27/97 P 175,000 $.625 1,555,000 D
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
- -------------------------- ---------- ------ ---- -------- ------ ------ -------------- ------------ -------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If this form is filed by more than one person, see instruction 4(b)(v).
SEC 1474 (7/96)
<PAGE>
FORM 4 (continued)
<TABLE>
<CAPTION>
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 6. Date Exercisable
(Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration
Price of (Month/Day/ (Instr. 8) or Disposed of (D) Date
Derivative Year) (Instr. 3 and 4) (Month/Day/
Security Year)
--------------- -------------------------- -------------------
Code V (A) (D) Date Expiration
Exer- Date
cisable
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
- ------------------------------- -------------- -------------- -------- ----- --------------- ---------- -------- ----------
</TABLE>
<TABLE>
<CAPTION>
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership Form 11. Nature of Indirect
Underlying Securities Security (Instr. 5) Securities Beneficially of Derivative Security: Beneficial Ownership
(Instr. 3 and 4) Owned at End of Month Direct (D) or (Instr. 4)
(Instr. 4) Indirect (I) (Instr. 4)
- ------------------------
Title Amount or
Number of
Shares
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
<S> <C> <C> <C> <C>
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
- ------------------------ ---------------------- -------------------------- --------------------------- ------------------------
</TABLE>
Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Benjamin A. DeMotto 9/10/97
----------------------- -------
Benjamin A. DeMotto Date
/s/ Patricia L. DeMotto 9/10/97
----------------------- -------
Patricia L. DeMotto Date
Benjamin A. DeMotto and Patricia L. DeMotto Living Trust
. /s/ Benjamin A. DeMotto 9/10/97
----------------------- -------
Benjamin A. Demotto Date
Trustee
. /s/ Patricia L. DeMotto 9/10/97
----------------------- -------
Patricia L. DeMotto Date
Trustee
Note: File three copies of this Form, one of which must be manually signed. If
space provided is insufficient, see Instruction 6 for procedure.
----------------
Date
SEC 1474 (7-96)
