This rule was filed as 13 NMAC 3.3.

TITLE 13 INSURANCE

CHAPTER 3 INSURANCE SECURITIES

PART 3 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES

13.3.3.1 ISSUING AGENCY: New Mexico State Corporation Commission [Public Regulation Commission], Department of Insurance, Post Office Box 1269, Santa Fe, NM 87504-1269.

[7/1/97; Recompiled 11/30/01]

13.3.3.2 SCOPE: This rule applies to every person who at any time during any calendar month was directly or indirectly the beneficial owner of more than 10 percent of any class of equity security of a domestic stock insurance company, or a director or officer of the company which is the issuer of such securities, and who during such month had any change in his beneficial ownership of any class of equity security of such company.

[7/1/97; Recompiled 11/30/01]

13.3.3.3 STATUTORY AUTHORITY: Sections 59A-2-9 and 59A-36-2 NMSA 1978.

[7/1/97; Recompiled 11/30/01]

13.3.3.4 DURATION: Permanent.

[7/1/97; Recompiled 11/30/01]

13.3.3.5 EFFECTIVE DATE: July 1, 1997, unless a later date is cited at the end of a section or paragraph.

[7/1/97; Recompiled 11/30/01]

[Compiler’s note: The words or paragraph, above, are no longer applicable. Later dates are now cited only at the end of sections, in the history notes appearing in brackets.]

13.3.3.6 OBJECTIVE: The purpose of this rule is to specify the requirements for filing a statement of changes in beneficial ownership of securities.

[7/1/97; Recompiled 11/30/01]

13.3.3.7 DEFINITIONS: [RESERVED]

13.3.3.8 WHEN STATEMENTS ARE TO BE FILED: Statements are required to be filed on the form prescribed in this rule on or before the 10th day after the end of each month in which any change in beneficial ownership has occurred. Statements are not deemed to have been filed with the superintendent of insurance until they have actually been received by him.

[7/1/97; Recompiled 11/30/01]

13.3.3.9 WHERE STATEMENTS ARE TO BE FILED: One signed copy of each statement shall be filed with the superintendent of insurance, Santa Fe, New Mexico.

[7/1/97; Recompiled 11/30/01]

13.3.3.10 SEPARATE STATEMENT FOR EACH COMPANY: A separate statement shall be filed with respect to the securities of each company.

[7/1/97; Recompiled 11/30/01]

13.3.3.11 RELATIONSHIP OF THE REPORTING PERSON TO COMPANY: Indicate clearly the relationship of the reporting person to the company; for example, “director”, “director and vice president”, “beneficial owner of more than 10 percent of the company’s common stock”, etc.

[7/1/97; Recompiled 11/30/01]

13.3.3.12 TRANSACTIONS AND HOLDINGS TO BE REPORTED: Every transaction shall be reported even though purchases and sales during the month are equal or the change involves only the nature of ownership; for example, from direct to indirect ownership. Beneficial ownership at the end of the month of all classes of securities required to be reported shall be shown even though there has been no change during the month in the ownership of securities of one or more classes.

[7/1/97; Recompiled 11/30/01]

13.3.3.13 TITLE OF SECURITY: The statement of the title of the security shall be such as clearly to identify the security even though there may be only one class; for example, “class A common stock”, “$6 convertible preferred stock”, “5% debentures due 1965”, etc.

[7/1/97; Recompiled 11/30/01]

13.3.3.14 DATE OF TRANSACTION: The exact date (month, day and year) of each transaction shall be stated opposite the amount involved in the transaction.

[7/1/97; Recompiled 11/30/01]

13.3.3.15 STATEMENT OF AMOUNTS OF SECURITIES: In stating the amount of the securities acquired, disposed of, or beneficially owned, give the face amount of debt securities or the number of shares or other units of other securities. In the case of securities owned indirectly, i.e., through a partnership, corporation, trust or other entity, the entire amount of securities involved in the transaction or owned by the partnership, corporation, trust, or other entity shall be stated. The person whose ownership is reported may, if he so desires, also indicate in a footnote, or other appropriate manner, the extent of his interest in the transaction or holdings of the partnership, corporation, trust or other entity.

[7/1/97; Recompiled 11/30/01]

13.3.3.16 NATURE OF OWNERSHIP: Under “nature of ownership”, state whether ownership of the securities is “direct” or “indirect”. If the ownership is indirect, i.e., through a partnership, corporation, trust or other entity, indicate in a footnote, or other appropriate manner, the name or identity of the medium through which the securities are indirectly owned. The fact that securities are held in the name of a broker or other nominee does not, of itself, constitute indirect ownership. Securities owned indirectly shall be reported on separate lines from those owned directly and from those owned through a different type of indirect ownership.

[7/1/97; Recompiled 11/30/01]

13.3.3.17 CHARACTER OF TRANSACTION: If the transaction was with the issuer of the securities, so state. If it involved the purchase of securities through the exercise of options, so state and give the exercise price per share. If any other purchase or sale was effected otherwise than in the open market, that fact shall be indicated. If the transaction was not a purchase or sale, indicate its character; for example, gift, five percent stock dividend, etc., as the case may be. The foregoing information may be appropriately set forth in the table or under “remarks” at the end of the table.

[7/1/97; Recompiled 11/30/01]

13.3.3.18 INCLUSION OF ADDITIONAL INFORMATION: A statement may include any additional information or explanation deemed relevant by the person filing the statement.

[7/1/97; Recompiled 11/30/01]

13.3.3.19 SIGNATURE: if the statement is filed for a corporation, partnership, trust, etc., the name of the organization shall appear over the signature of the officer or other person authorized to sign the statement. If the statement is filed for an individual, it shall be signed by him or specifically on his behalf by a person authorized to sign for him.

[7/1/97; Recompiled 11/30/01]

13.3.3.20 FORM SCBOS (1966 EDITION):

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES

(To be filed with the Department of Insurance pursuant to Section 59A-36-2 NMSA 1978.)

____________________________________________

(Name of insurance company)

____________________________________________

(Name of person whose ownership is reported)

____________________________________________

(Business address of such person) (street) (city) (state) (zip code)

____________________________________________

Social security number

____________________________________________

Relationship of such person to company named above. (See 13 NMAC 3.3.11) [now 13.3.3.11 NMAC]

STATEMENT FOR CALENDAR MONTH OF ________ , 19____

CHANGES DURING MONTH AND MONTH-END OWNERSHIP

(See 13 nmac 3.3.12) [now 13.3.3.12 NMAC]

Title Of Security (See 13 NMAC 3.3.13) [now 13.3.3.13 NMAC]

Date of Trans- Action (See 13 NMAC 3.3.14) [now 13.3.3.14 NMAC]

Amount Bought or otherwise (See 13 NMAC 3.3.15) [now 13.3.3.15 NMAC]

Amount Sold or otherwise (See 13 NMAC 3.3.15) [now 13.3.3.15 NMAC]

Nature Of Ownership (See 13 NMAC 3.3.16) [now 13.3.3.16 NMAC]

Amount Owned beneficially at end of month (See 13 NMAC 3.3.15) [now 13.3.3.15 NMAC]

REMARKS: (See 13 NMAC 3.3.17) [now 13.3.3.17 NMAC]

____________________________________________

Date of statement

I affirm under penalty or perjury that the foregoing is full, true and correct.

____________________________________________

Signature

____________________________________________

Signature guaranteed

[7/1/97; Recompiled 11/30/01]

HISTORY OF 13.3.3 NMAC:

Pre-NMAC History: The material in this rule was originally filed with the State Records Center as:

ID 67-1, Sections 4-1-1 through 4-1-14, New Mexico Official Administrative Rules and Regulations Code, on 12/1/67.

History of Repealed Material: [RESERVED]