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U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
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FORM 3 OMB Number: 3235-0104
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Estimated average burden
hours per response .... 0.5
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1. Name and Address of Reporting Person *
Capital Z Partners, Ltd.
(Last) (First) (Middle)
One Chase Manhattan Plaza, 44th Floor
(Street)
New York NY 10005
(City) (State) (Zip)
2. Date of Event Requiring Statement ( Month / Day / Year )
12/10/98
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Issuer Name and Ticker or Trading Symbol
Superior National Insurance Group, Inc. (SNTL)
5. Relationship of Reporting Person to Issuer (Check all applicable)
Director X 10% Owner
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Officer (give title Other
----- below) ----- (specify
below)
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6. If Amendment, Date or Original (Month/Year)
7. Individual or Join/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
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Form filed by More than One Reporting Person
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TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
1. Title of security 2. Amount of Securities 3. Ownership 4. Nature of Indirect
(Inst.4) Beneficially Owned Form: Direct (D) Beneficial Ownership
(Instr. 4) or Indirect (I) (Instr. 5)
(Inst. 5)
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Common Stock 5,276,960 I By indirect general partnership
interest in Capital Z Financial
Services Fund II, L.P.
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the Form is filed by more than one reporting person, SEE instruction 5(b)(v). SEC 1473(8-92)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS,
CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
1. Title of Derivative Security 2. Date Exercisable and 3. Title and Amount of Securities Underlying
(Instr. 4) Expiration Date Derivative Security (Instr. 4)
(Month/Day/Year)
Amount or
Date Expiration Title Number of
Exercisable Date Shares
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4. Conversion or 5. Ownership 6. Nature of Indirect
Exercise Price of Form of Beneficial Ownership
Derivative Derivative (Instr. 5)
Security Security:
Direct (D) or
Indirect (I)
(Instr. 5)
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Explanation of Responses:
The reporting person disclaims beneficial ownership of these securities to the
extent of its pecuniary interest therein.
**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 provided is insufficient, SEE Instruction 6 for procedure.
CAPITAL Z PARTNERS, LTD.
/s/ Robert A. Spass December 21, 1998
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** Signature of Reporting Person Date
Robert A. Spass, Deputy Chairman of the Board
Page 2
SEC 1473 (8-92)
