UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. 4)*
WALSHIRE ASSURANCE COMPANY
(Name of Issuer)
COMMON STOCK, PAR VALUE $.01 PER SHARE
(Title of Class of Securities)
933132102
(CUSIP Number)
Check the following box if a fee is being paid with this statement.
(A fee is not required only if the filing person: (1) has a previous
statement on file reporting beneficial ownership of more than five percent
of the class of securities described in Item 1; and (2) has filed no
amendment subsequent thereto reporting beneficial ownership of five
percent or less of such class.) (See Rule 13d-7).
*The remainder of this cover page shall be filled out for a reporting
person s initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which
would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be filed for the purpose of Section 18 of the Securities
Exchange Act of 1934 ( Act ) or otherwise subject to the liabilities of
that section of the Act but shall be subject to all other provisions of
the Act (however, see the Notes).
Page 1 of 5 pages
SEC 1745 (2/92)
CUSIP No. 933132102 13G
1 NAME OF REPORTING PERSON
S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
L. Edward Sausman
###-##-####
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a)
(b) x
3 SEC USE ONLY
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
5 SOLE VOTING POWER
NUMBER OF 260,586 Shares (See Note 1 to Item 4)
SHARES
BENEFICIALLY 6 SHARED VOTING POWER
OWNED 10,969 Shares (See Notes 2 and 3 to Item 4)
BY
EACH 7 SOLE DISPOSITIVE POWER
REPORTING 260,586 Shares (See Note 1 to Item 4)
PERSON
WITH 8 SHARED DISPOSITIVE POWER
10,969 Shares (See Notes 2 and 3 to Item 4)
9 AGGREGATE AMOUNT BENEFICALLY OWNED BY EACH REPORTING PERSON
271,555 Shares (See Notes 1, 2 and 3 to Item 4)
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES*
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
5.79% (See Note 4 to Item 4)
12 TYPE OF REPORTING PERSON*
In
*SEE INSTRUCTION BEFORE FILLING OUT!
Page 2 of 5 pages
CUSIP No. 933132102 13G
1 NAME OF REPORTING PERSON
S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Beverly G. Sausman
###-##-####
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a)
(b) x
3 SEC USE ONLY
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
5 SOLE VOTING POWER
NUMBER OF 10,660 Shares (See Note 3 to Item 4)
SHARES
BENEFICIALLY 6 SHARED VOTING POWER
OWNED 260,895 Shares (See Notes 1 and 2 to Item 4)
BY
EACH 7 SOLE DISPOSITIVE POWER
REPORTING 10,660 Shares (See Note 3 to Item 4)
PERSON
WITH 8 SHARED DISPOSITIVE POWER
260,895 Shares (See Notes 1 and 2 to Item 4)
9 AGGREGATE AMOUNT BENEFICALLY OWNED BY EACH REPORTING PERSON
271,555 Shares (See Notes 1, 2 and 3 to Item 4)
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN
SHARES*
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
5.79% (See Note 4 to Item 4)
12 TYPE OF REPORTING PERSON*
In
*SEE INSTRUCTION BEFORE FILLING OUT!
Page 3 of 5 pages
Item 1. Name and Address of Issuer.
(a) This Statement relates to the common stock, par value $.01
per share (the Common Stock ), of Walshire Assurance
Company (the Company ).
(b) The Company s principal executive offices are located at
3350 Whiteford Road, P. O. Box 3849, York, PA 17402-0138.
Item 2. Name, Address and Citizenship of Person Filing, Title of
Class of Securities and CUSIP Number.
(a) This Statement is filed by L. Edward Sausman, Jr. and
Beverly G. Sausman.
(b) The address of Mr. and Mrs. Sausman s business office
is P. O. Box 158, Thompsontown, PA 17094.
(c) Mr. and Mrs. Sausman are citizens of the United States.
(d) Title of Class of Securities: Common Stock, par value $.01
per shares.
(e) CUSIP Number: 933132102.
Item 3. Statement Filed Pursuant to Rules 13d-1(b) or 13d-2(b).
Not Applicable.
Item 4. Ownership.
(a) Items 5, 6, 7, 8, 9 and 11 from Pages 2 and 3 of this
Statement are incorporated by reference. The filing of this
Statement shall not be construed as an admission that the
reporting person is for the purpose of Section 13(d) or
13(g) of the Securities Exchange Act of 1934, as amended,
the beneficial owner of any of the securities covered by
this Statement.
Note 1. Such amount includes: (i) 223,744 shares of Common
Stock which are owned individually by Mr. Sausman, Jr. and
(ii) 36,842 shares of Common Stock which are issuable
pursuant to options granted to Mr. Sausman, Jr. which are
exercisable within 60 days from the date of this Statement.
Note 2. Such amount represents 309 shares of Common Stock
owned jointly by L. Edward Sausman, Jr. and Beverly G.
Sausman.
Note 3. Such amount represents 10,660 shares of Common Stock
owned individually by Mrs. Sausman.
Page 4 of 5 pages
Note 4. This percentage is obtained by dividing the amount
of shares of Common Stock beneficially owned by Mr. and Mrs.
Sausman, Jr. by the sum of (i) 4,650,713 shares of Common
Stock, the number of issued and outstanding shares of common
stock as of the most recent practicable date and (ii) 36,842
shares of Common Stock which are issuable as described in
Note 1 above.
Item 5. Ownership of Five Percent or Less of a Class.
Not Applicable.
Item 6. Ownership of More than Five Percent on Behalf of Another
Person.
Not Applicable.
Item 7. Identification and Classification of the Subsidiary which
Acquired the Security being Reported on by the Parent
Holding Company.
Not Applicable.
Item 8. Identification and Classification of Members of the Group.
Not Applicable.
Item 9. Notice of Dissolution of Group.
Not Applicable.
Item 10. Certification.
Not Applicable.
Signature.
After reasonable inquiry and to the best of my knowledge and belief,
I certify that the information set forth in this Statement is true,
complete and correct.
Dated: January 20, 1997
L. Edward Sausman, Jr.
Beverly G. Sausman
Page 5 of 5 pages
