# EDGAR Filing Document

**Accession Number:** 0001196567
**File Stem:** 0001567619-23-001134
**Filing Date:** 2023-1
**Character Count:** 7635
**Document Hash:** 68ca8aa067838c13b00f008981831943
**Contains OCR:** False
**Source Format:** 

## Filing Content

## Filing Summary
**0001567619-23-001134.hdr.sgml**: 20230123

**ACCESSION NUMBER**: 0001567619-23-001134

**CONFORMED SUBMISSION TYPE**: 4

**PUBLIC DOCUMENT COUNT**: 1

**CONFORMED PERIOD OF REPORT**: 20221230

**FILED AS OF DATE**: 20230123

**DATE AS OF CHANGE**: 20230123

**REPORTING-OWNER**: 

**OWNER DATA:**
- **COMPANY CONFORMED NAME:** ROBINSON HARRIETT J
- **CENTRAL INDEX KEY:** 0001196567

**FILING VALUES:**
- **FORM TYPE:** 4
- **SEC ACT:** 1934 Act
- **SEC FILE NUMBER:** 000-03722
- **FILM NUMBER:** 23544687
**ISSUER**: 

**COMPANY DATA:**
- **COMPANY CONFORMED NAME:** ATLANTIC AMERICAN CORP
- **CENTRAL INDEX KEY:** 0000008177
- **STANDARD INDUSTRIAL CLASSIFICATION:** LIFE INSURANCE [6311]
- **IRS NUMBER:** 581027114
- **STATE OF INCORPORATION:** GA
- **FISCAL YEAR END:** 1231

**BUSINESS ADDRESS:**
- **STREET 1:** 4370 PEACHTREE RD NE
- **CITY:** ATLANTA
- **STATE:** GA
- **ZIP:** 30319
- **BUSINESS PHONE:** 4042665500

**MAIL ADDRESS:**
- **STREET 1:** 4370 PEACHTREE ROAD
- **CITY:** ATLANTA
- **STATE:** GA
- **ZIP:** 30319

### 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. See Instruction 1(b).

[ ] Check this box to indicate that a transaction was made pursuant to a contract, instruction or written plan for the purchase or sale of equity securities of the issuer that is intended to satisfy the affirmative defense conditions of Rule 10b5-1(c). See Instruction 10.

---

| | | |
|:---|:---|:---|
| **1. Name and Address of Reporting Person**<sup>*</sup><br>ROBINSON HARRIETT J<br><sub>(Last) (First) (Middle)</sub><br>4370 PEACHTREE ROAD, N.E.<br><sub>(Street)</sub><br>ATLANTA, GA 30319<br><sub>(City) (State) (Zip)</sub> | **3. Date of Earliest Transaction (Month/Day/Year)**<br>2022-12-30 | **5. Relationship of Reporting Person(s) to Issuer**<br>(Check all applicable)<br>[ ] Director [X] 10% Owner<br>[ ] Officer (give title below) [X] Other (specify below)<br>_Trustee under Rule 16a-8_ |
| **2. Issuer Name and Ticker or Trading Symbol**<br>ATLANTIC AMERICAN CORP [ AAME ] | **4. If Amendment, Date of Original Filed (Month/Day/Year)**<br>  | **6. Individual or Joint/Group Filing (Check Applicable Line)**<br>[X] Form filed by One Reporting Person<br>[ ] Form filed by More than One Reporting Person |

---

## Table I - Non-Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | 3. Transaction Code (V) | 3. Transaction Code (V) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 4. Securities Acquired (A) or Disposed of (D) | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| 1. Title of Security | 2. Transaction Date | 2A. Deemed Execution Date | Code | V | Amount | (A) or (D) | Price | 5. Amount of Securities Beneficially Owned | 6. Ownership Form | 7. Nature of Indirect Beneficial Ownership |
| Common Stock | 2022-12-30 |  | P<sup>(1)</sup> |  | 300000 | A<sup>(1)</sup> | $3.00 | 1130259 | D |  |
| Common Stock | 2022-12-30 |  | S<sup>(1)</sup> |  | 300000 | D<sup>(1)</sup> | $3.00 | 0 | I | By Delta Fire & Casualty Insurance Company |
| Common Stock |  |  |  |  |  |  |  | 5120555<sup>(2)</sup> | I | By Gulf Capital Services |
| Common Stock |  |  |  |  |  |  |  | 3954281<sup>(3)</sup> | I | As Trustee |
| Common Stock |  |  |  |  |  |  |  | 4092767<sup>(4)</sup> | I | As Trustee |
| Common Stock |  |  |  |  |  |  |  | 408765<sup>(5)</sup> | I | As Trustee |
| Common Stock |  |  |  |  |  |  |  | 510956<sup>(5)</sup> | I | As Trustee |

---

## Table II - Derivative Securities

---

|  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |
| --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- | --- |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | 4. Transaction Code (V) | 4. Transaction Code (V) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) | 6. Date Exercisable and Expiration Date | 6. Date Exercisable and Expiration Date | 7. Title and Amount of Underlying Securities | 7. Title and Amount of Underlying Securities | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| 1. Title of Derivative Security | 2. Conversion or Exercise Price | 3. Transaction Date | 3A. Deemed Execution Date | Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | 8. Price of Derivative Security | 9. Number of Derivative Securities Beneficially Owned | 10. Ownership Form | 11. Nature of Indirect Beneficial Ownership |
| Series D Preferred Stock | <sup>(6)</sup> |  |  |  |  |  |  | <sup>(7)</sup> | <sup>(7)</sup> | Common Stock | 1378446 |  | 55000 | I | By Delta Life Insurance Company |

---

### Footnotes:

(1) Represents change in nature of Reporting Person's ownership as a result of the transfer of shares by private sale to Harriett J. Robinson from her affiliate Delta Fire & Casualty Insurance Company.

(2) Shares owned by Gulf Capital Services, an entity in which interests are held in equal amounts by trusts for the benefit of Mrs. Robinson's two daughters, and of which Mrs. Robinson serves as trustee.  Mrs. Robinson disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein, if any.

(3) Mrs. Robinson serves as trustee of a trust for the benefit of her daughter, Robin  R. Howell.  Mrs. Robinson disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein.

(4) Mrs. Robinson serves as trustee of a trust for the benefit of her daughter, Jill Robinson.  Mrs. Robinson disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein.

(5) Mrs. Robinson serves as trustee of a trust for the benefit of her grandchildren. Mrs. Robinson disclaims beneficial ownership of such shares except to the extent of her pecuniary interest therein.

(6) The Series D Preferred Stock is convertible into common stock at a per share price of $3.99, subject to certain anti-dilution provisions, provided that in no case may the conversion price be less than $2.59 per share without the prior approval of the Company's shareholders.  Such shares are owned by Delta Life Insurance Company and Mrs. Robinson disclaims beneficial ownership of such shares.

(7) The Series D Preferred Stock is not currently convertible into common stock .

**Signature:** /s/ Harriett J. Robinson  
**Date:** 2023-01-23

### Remarks:

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).

** 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 is insufficient, see Instruction 6 for procedure.

**Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.**