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UNITED STATES | OMB Number: 3235-0101 | |||||||||||||||||||||||||||||||||||||||||||||||||
SECURITIES AND EXCHANGE COMMISSION | Expires : December 31, 2009 | |||||||||||||||||||||||||||||||||||||||||||||||||
Washington, D.C. 20549 | Estimated average burden | |||||||||||||||||||||||||||||||||||||||||||||||||
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FORM 144 | SEC USE ONLY | |||||||||||||||||||||||||||||||||||||||||||||||||
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| DOCUMENT SEQUENCE NO. | |||||||||||||||||||||||||||||||||||||||||||||
NOTICE OF PROPOSED SALE OF SECURITIES |
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PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933 | CUSIP NUMBER | |||||||||||||||||||||||||||||||||||||||||||||||||
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ATTENTION: Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute a sale | WORK LOCATION | |||||||||||||||||||||||||||||||||||||||||||||||||
or executing a sale directly with a market maker. |
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1 (a) NAME OF ISSUER (Please type or print) | (b) IRS IDENT. NO. | (c) S.E.C. FILE NO. |
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American Physicians Service Group, Inc. | 75-1458323 | 001-31434 |
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1 (d) ADDRESS OF ISSUER |
| STREET | CITY STATE ZIP CODE | (e) TELEPHONE NO. |
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| AREA CODE | NUMBER | |||||||||||||||||||||||||||||||||||||||||||||
1301 Capital of Texas Hwy. suite C-300 | Austin | TX | 78746 | 512 | 328-0888 | |||||||||||||||||||||||||||||||||||||||||||||
2 (a) NAME OF PERSON FOR WHOSE ACCOUNT THE SECURITIES ARE TO BE SOLD | (b) SOCIAL SECURITY NO. OR IRS IDENT. NO. | (c) RELATIONSHIP TO ISSUER | (d) ADDRESS | STREET | CITY STATE ZIP CODE | |||||||||||||||||||||||||||||||||||||||||||||
Kenneth S. Shifrin | ###-##-#### | officer | 15801 Chateau | Ausitn, TX | 78734 | |||||||||||||||||||||||||||||||||||||||||||||
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| INSTRUCTION: | The person filing this notice should contact the issuer to obtain the IRS. Identification Number and the S.E.C. File Number. |
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3(a) | (b) | SEC USE ONLY | (c) | (d) | (e) | (f) | (g) | |||||||||||||||||||||||||||||||||||||||||||
Title of the Class of Securities To Be Sold | Name and Address of Each Broker Through Whom the Securities are to be Offered or Each Market Maker who is Acquiring the Securities | Broker-Dealer File Number | Number of Shares or Other Units To Be Sold (See instr. 3(c)) | Aggregate Market Value (See instr. 3(d)) | Number of Shares or Other Units Outstanding (See instr. 3(e)) | Approximate Date of Sale (See instr. 3(f)) (MO. DAY YR.) | Name of Each Securities Exchange (See inst. 3(g)) | |||||||||||||||||||||||||||||||||||||||||||
Common stock | Raymond James Tampa, FL |
| 18,000 | $337,140 (11-29-2007) | 7,173,411 (11-29-2007) | 11-29-2007 | Nasdaq | |||||||||||||||||||||||||||||||||||||||||||
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INSTRUCTIONS:
1.
(a)
Name of issuer
3.
(a)
Title of the class of securities to be sold
(b)
Issuer’s I.R.S. Identification Number
(b)
Name and address of each broker through whom the securities are intended to be sold
(c)
Issuer’s S.E.C. file number, if any
(c)
Number of shares or other units to be sold (if debt securities, give the aggregate face amount)
(d)
Issuer’s address, including zip code
(d)
Aggregate market value of the securities to be sold as of a specified date within 10 days prior to the filing of this notice.
(e)
Issuer’s telephone number, including area code
(e)
Number of shares or other units of the class outstanding, or if debt securities the face amount thereof outstanding,
as shown by the most recent report or statement published by the issuer
2.
(a)
Name of person for whose account the securities are to be sold
(f)
Approximate date on which the securities are to be sold
(b)
Such person’s I.R.S. identification number- if such person is an entity
(g)
Name of each securities exchange, if any, on which the securities are intended to be sold
(c)
Such person’s relationship to the issuer (e.g., officer, director, 10%
stockholder, or member of immediate family of any of the foregoing)
(d)
Such person’s address, including zip code
Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Control number.
SEC 1147 (01-04)
TABLE I ----- SECURITIES TO BE SOLD
Furnish the following information with respect to the acquisition of the securities to be sold
and with respect to the payment of all or any part of the purchase price or other consideration therefore:
Title of the Class | Date You Acquired | Nature of Acquisition Transaction | Name of Person from Whom Acquired (If gift, also give date donor acquired) | Amount of Securities Acquired | Date of Payment | Nature of Payment |
Common stock | 10-10-2003 | Stock option exercise | American Physicians Service Group, Inc. | 60,000 | 10-10-2003 | Cash |
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INSTRUCTIONS:
If the securities were purchased and full payment therefor was not made in cash at the
time of purchase, explain in the table or in a note thereto the nature of the consideration
given. If the consideration consisted of any note or other obligation, or if payment was
made in installments describe the arrangement and state when the note or other obligation
was discharged in full or the last installment paid.
TABLE II --- SECURITIES SOLD DURING THE PAST 3 MONTHS
Furnish the following information as to all securities of the issuer sold during the past 3 months by
the person for whose account the securities are to be sold.
Name and Address of Seller | Title of Securities Sold | Date of Sale | Amount of Securities Sold | Gross Proceeds |
Kenneth S. Shifrin 15801 Chateau Austin, TX 78734 | Common Stock Common Stock | 09-05-2007 11-07-2007 | 75,400 2,000 | 1,345,905 41,100 |
REMARKS:
INSTRUCTIONS:
ATTENTION:
See the definition of “person” in paragraph (a) of Rule 144. Information is to be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice. |
| The person for whose account the securities to which this notice relates are to be sold hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publicly disclosed. |
12-03-2007
/X/ Kenneth S. Shifrin
DATE OF NOTICE
The notice shall be signed by the person for whose account the securities are to be sold. At least one copy
of the notice shall be manually signed. Any copies not manually signed shall bear typed or printed signatures.
ATTENTION: Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001).
SEC 1147 (01-04)