SEC FORM 5 SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response: 1.0
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
Form 3 Holdings Reported.
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Quist S. Andrew

(Last) (First) (Middle)
272 EAST BROADLEAF CIRCLE

(Street)
DRAPER UT 84020

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
SECURITY NATIONAL FINANCIAL CORP [ SNFCA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
VP; Assoc General Counsel
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2017
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Class A Common Stock 12/19/2017 G 4,000 D $0 6,532(1) D
Class A Common Stock 12/22/2017 G 4,000 D $0 2,532(1) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Employee Stock Option (right to buy) $0.96(2) 12/02/2011 A 20,012(2) 03/02/2012 12/02/2021 Class A Common Stock 20,012(2) $0.96(2) 20,012(2) D
Employee Stock Option (right to buy) $1.21(3) 04/13/2012 A 19,145(3) 07/13/2012 04/13/2022 Class A Common Stock 19,145(3) $1.21(3) 19,145(3) D
Employee Stock Option (right to buy) $3.95(4) 12/06/2013 A 12,155(4) 03/06/2014 12/06/2023 Class A Common Stock 12,155(4) $3.95(4) 12,155(4) D
Employee Stock Option (right to buy) $3.69(5) 07/02/2014 A 11,576(5) 10/02/2014 07/02/2024 Class A Common Stock 11,576(5) $3.69(5) 11,576(5) D
Employee Stock Option (right to buy) $4.3(6) 12/05/2014 A 23,153(6) 03/05/2015 12/05/2024 Class A Common Stock 23,153(6) $4.3(6) 23,153(6) D
Employee Stock Option (right to buy) $6.06(7) 12/04/2015 A 23,153(7) 03/04/2016 12/04/2025 Class A Common Stock 23,153(7) $6.06(7) 23,153(7) D
Employee Stock Option (right to buy) $6.68(8) 12/02/2016 A 21,000(8) 03/02/2017(8) 12/02/2026 Class A Common Stock 21,000(8) $6.68(8) 21,000(8) D
Employee Stock Option (right to buy) $5.05(9) 12/01/2017 A 20,000(9) 03/01/2018(9) 12/01/2027 Class C Common Stock 20,000(9) $5.05(9) 20,000(9) D
Explanation of Responses:
1. Does not include 46,646 shares of Class A Common Stock owned indirectly by the reporting person in the 401(k) Retirement Plan.
2. This option was granted on December 2, 2011 as an option for 15,000 shares of Class A Common Stock at an exercise price of $1.30 per share, but adjusted pursuant to the anti-dilution provisions of the 2003 Stock Option Plan to reflect 5% stock dividends paid on February 3, 2012, February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016 and February 3, 2017.
3. This option was granted on April 14, 2012 as an option for 15,000 shares of Class A Common Stock at an exercise price of $1.56 per share, but adjusted pursuant to the anti-dilution provisions of the 2003 Stock Option Plan to reflect 5% stock dividends paid on February 1, 2013, February 7, 2014, February 6, 2015, February 5, 2016 and February 3, 2017.
4. This option was granted on December 6, 2013 as an option for 10,000 shares of Class A Common Stock at an exercise price of $4.85 per share, but adjusted pursuant to the anti-dilution provisions of the 2003 Stock Option Plan to reflect 5% stock dividends paid on February 7, 2014, February 6, 2015, February 5, 2016 and February 3, 2017.
5. This option was granted on July 2, 2014 as an option for 10,000 shares of Class A Common Stock at an exercise price of $4.29 per share but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 6, 2015, February 5, 2016 and February 3, 2017.
6. This option was granted on December 5, 2014 as an option for 20,000 shares of Class A Common Stock at an exercise price of $5.02 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 6, 2015, February 5, 2016 and February 3, 2017.
7. This option was granted on December 4, 2015 as an option for 20,000 shares of Class A Common Stock at an exercise price of $6.72 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 5, 2016 and February 3, 2017.
8. This option was granted on December 2, 2016 as an option for 20,000 shares of Class A Common Stock at an exercise price of $7.03 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect a 5% stock dividend paid on February 3, 2017.
9. This option was granted on December 1, 2017 as an option for either 20,000 shares of Class A Common Stock at an exercise price of $5.05 per share or 20,000 shares of Class C Common Stock at an exercise price of $5.05 per share, or any combination thereof. This option reflects the reporting person's election to have an option for 20,000 shares of Class C Common Stock at an exercise price of $5.05 per share. This option vests in four equal quarterly installments of Class C Common Stock, beginning on March 1, 2018, until such shares are fully vested.
/s/S. Andrew Quist 01/04/2018
** Signature of Reporting Person Date
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.