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Previous: ALLIED LIFE FINANCIAL CORP, 4, 1998-10-09 |
Next: ALLIED LIFE FINANCIAL CORP, 8-K, 1998-10-09 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] Check this box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue.
1. Name and Address of Reporting Person(s)
SAMUEL J. WELLS
701 5th Ave
Des Moines, IA 50391-2003
2. Issuer Name and Ticker or Trading Symbol
ALLIED Life Financial Corporation (ALFC)
3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
4. Statement for Month/Year
09/98
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
[ ] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
President
7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[ ] 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) 7)Nature of
action action or Disposed of (D) Securities Indirect
Date Code A Beneficially D Beneficial
(Month/ or Owned at or Ownership
Day/Year) Code V Amount D Price End of Month I
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C><C> <C> <C><C>
Common Stock 09/23/98 M 5,766.0000 A $12.0000 D Direct
Common Stock 09/23/98 M (1) 175.0000 A $12.8750 D Direct
Common Stock 09/23/98 D (1) 175.0000 D $29.5000 D Direct
Common Stock 09/23/98 M (1) 175.0000 A $15.2500 D Direct
Common Stock 09/23/98 D (1) 175.0000 D $29.5000 D Direct
Common Stock 09/23/98 M (1) 175.0000 A $17.6250 D Direct
Common Stock 09/23/98 D (1) 175.0000 D $29.5000 D Direct
Common Stock 09/23/98 M 500.0000 A $12.8750 D Direct
Common Stock 09/23/98 M 500.0000 A $12.8750 D Direct
Common Stock 09/23/98 M 500.0000 A $15.2500 D Direct
Common Stock 09/23/98 M 500.0000 A $15.2500 D Direct
Common Stock 09/23/98 M 500.0000 A $17.6250 D Direct
Common Stock 09/23/98 M 500.0000 A $17.6250 62,405.1007 D Direct
<CAPTION>
Table II (PART 1) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6)
- ------------------------------------------------------------------------------------------------------------------------------------
1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and
Security or Exercise action action Securities Acquired (A) Expiration Date
Price of Date Code or Disposed of (D)
Derivative
Security Code V A D Exercisable Expiration
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Incentive Stock Option (right $12.8750 09/23/98 M 500.0000 03/31/98 03/31/04
to buy)
Incentive Stock Option (right $15.2500 09/23/98 M 500.0000 03/31/98 03/31/05
to buy)
Incentive Stock Option (right $17.6250 09/23/98 M 500.0000 03/22/98 03/22/06
to buy)
Non-Qualified Stock Option $12.0000 09/23/98 M 5,766.0000 11/17/97 11/17/03
(right to buy)
Non-Qualified Stock Option $12.8750 09/23/98 M 500.0000 03/31/98 03/31/04
(right to buy)
Non-Qualified Stock Option $15.2500 09/23/98 M 500.0000 03/31/98 03/31/05
(right to buy)
Non-Qualified Stock Option $17.6250 09/23/98 M 500.0000 03/22/98 03/22/06
(right to buy)
SAR $12.8750 09/23/98 M (1) 175.0000 03/31/98 03/31/04
SAR $15.2500 09/23/98 M (1) 175.0000 03/31/98 03/31/05
SAR $17.6250 09/23/98 M (1) 175.0000 03/22/98 03/22/06
<CAPTION>
Table II (PART 2) Derivative Securities Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11)
- ------------------------------------------------------------------------------------------------------------------------------------
1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of
Security action of Underlying of Deri- Derivative Indirect
Date Securities vative Securities D Beneficial
Amount or Security Beneficially or Ownership
Number of Owned at I
- Title Shares End of Month
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Incentive Stock Option (right 09/23/98 Common Stock 500.0000 500.0000 D Direct
to buy)
Incentive Stock Option (right 09/23/98 Common Stock 500.0000 1,000.0000 D Direct
to buy)
Incentive Stock Option (right 09/23/98 Common Stock 500.0000 1,500.0000 D Direct
to buy)
Non-Qualified Stock Option 09/23/98 Common Stock 5,766.0000 17,768.0000 D Direct
(right to buy)
Non-Qualified Stock Option 09/23/98 Common Stock 500.0000 500.0000 D Direct
(right to buy)
Non-Qualified Stock Option 09/23/98 Common Stock 500.0000 1,000.0000 D Direct
(right to buy)
Non-Qualified Stock Option 09/23/98 Common Stock 500.0000 1,500.0000 D Direct
(right to buy)
SAR 09/23/98 Common Stock 175.0000 175.0000 D Direct
SAR 09/23/98 Common Stock 175.0000 350.0000 D Direct
SAR 09/23/98 Common Stock 175.0000 525.0000 D Direct
<FN>
Explanation of Responses:
(1)
Exercise of SAR for cash.
</FN>
</TABLE>
SIGNATURE OF REPORTING PERSON
/S/ SAMUEL J. WELLS
DATE
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