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FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
OMB APPROVAL
OMB NUMBER 3235-0287
EXPIRES: SEPTEMBER 30, 1998
ESTIMATED AVERAGE BURDEN
HOURS PER RESPONSE . . . . 0.5
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 THIS BOX IF NO LONGER
SUBJECT TO SECTION 16. FORM 4
OR FORM 5 OBLIGATIONS MAY
CONTINUE. SEE INSTRUCTION 1(b).
(Print or Type Responses)
1. Name and Address of Reporting Person
Charles H. Lubochinski
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(Last) (First) (Middle)
3 Bethesda Metro Center, Suite 1600
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(Street)
Bethesda MD 20814
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(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
PennCorp Financial Group, Inc. (PFG)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
November 1996
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer (Check all applicable)
Director 10% Owner
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X Officer (give title below) Other (specify below)
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7. Individual or Joint/Group Filing (Check Applicable)
X 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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY
OWNED
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<CAPTION>
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1. Title of Security 2. Transaction Date 3. Transaction Code 4. Securities Acquired (A) or
(Instr. 3) (Month/Day/Year) (Instr.8) Disposed of (D) (Instr. 3, 4
and 5)
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Code / V Amount / (A) or (D) / Price
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<S> <C> <C> <C>
Common Stock (1) 11/26/96 M 1,000 A $5.40
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Common Stock
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5. Amount of Securities 6. Ownership Form: Direct 7. Nature of Indirect
Beneficially Owned (D) or Indirect (I) Beneficial Ownership
at End of Month (Instr. 4) (Instr. 4)
(Instr. 3 and 4)
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<S> <C> <C> <C>
Common Stock (1) 3,000 D
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Common Stock 100 I (2) by Trust
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the form filed by more than one reporting person, see Instruction 4(b)(v) SEC 1474 (7/96)
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FORM 4 (CONTINUED)
TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative 2. Conversion or 3. Transaction 4. Transaction 5. Number of Derivative 6. Date Exercisable and
Security (Instr. 3) Exercise Price Date (Month/ Code (Instr. 8) Securities Acquired Expiration Date
of Derivative Day/Year) (A) or Disposed of (Month/Day/Year)
Security (D) (Instr. 3, 4,
and 5)
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Code / V (A) / (D) Date Expiration
Exercisable Date
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
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Incentive Stock Option
(right to buy) (1) $5.40 11/26/96 M 1,000 04/03/96 04/03/97
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<CAPTION>
7. Title and Amount 8. Price of 9. Number of 10. Ownership 11. Nature of
of Underlying Derivative Derivative Form of Indirect
Securities (Instr. Security Securities Derivative Beneficial
3 and 4) (Instr. 5) Beneficially Security: Ownership
Owned at Direct (D) (Instr. 4)
Amount or End of or Indirect
Number of Month (I) (Instr. 4)
Title Shares (Instr. 4)
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<S> <C> <C> <C> <C> <C>
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Incentive Stock Option
(right to buy) (1) Common Stock 1,000 $5.40 4,000 D
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Explanation of Responses:
(1) Represents options granted under the Company's 1992 Stock Option Plan which
options expire if not exercised by April 3, 1997.
(2) Shares are held in an irrevocable Trust, of which Mr. Lubochinski is Sole
Trustee, for the benefit of Mr. Lubochinski's son.
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<S> <C>
** Intentional misstatements or omissions of facts constitute /s/ CHARLES H. LUBOCHINSKI 12/10/96
Federal Criminal Violations. See 18 U.S.C. 1001 and 15 ----------------------------- ----------
U.S.C. 78ff(a). ** Signature of Date
Reporting Person
Note: File three copies of this Form, one of which must
be manually signed. If space provided is insufficient,
see Instruction 6 for procedure.
Potential persons who are to respond to the collection of information contained in this Page 2
form are not required to respond unless the form displays the currently valid OMB Number. SEC 1474 (7/96)
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