Insider Trading Reporting Forms And Instructions Page 3

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Exhibit 1
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OAR 836-024-0115
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FORM 3 - INSTRUCTIONS
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1.
PERSONS REQUIRED TO FILE STATEMENTS
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A statement on this form is required to be filed by every person who is directly or indirectly the
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beneficial owner of more than 10 percent of any class of any equity security of a domestic stock
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insurance company, or who is a director or an officer of such a company.
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2.
WHEN STATEMENTS ARE TO BE FILED
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A.
Persons who hold any of the relationships specified in Instruction 1 are required to file a
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statement within 10 days after assuming such relationship, whichever date is later.
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B.
Statements are not deemed to have been filed with the Director until they have actually
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been received by the Director.
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3.
WHERE STATEMENTS ARE TO BE FILED
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One signed copy of each statement shall be filed with the Director of the Department of
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Consumer and Business Services, [address].
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4.
SEPARATE STATEMENT FOR EACH COMPANY
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A separate statement shall be filed with respect to the securities of each company.
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5.
RELATIONSHIP OF REPORTING PERSON TO COMPANY
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Indicate clearly the relationship of the reporting person to the company; for example, “Director,”
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“Director and Vice President,” “Beneficial owner of more than 10 percent of the company’s
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common stock,” etc.
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6.
DATE AS OF WHICH BENEFICIAL OWNERSHIP IS TO BE GIVEN
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The information as to beneficial ownership of securities shall be given as of [insert month, day],
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1965, or, in the case of persons who subsequently assume any of the relationships specified in
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Instruction 1, as of the date that relationship was assumed.
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7.
TITLE OF SECURITY
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The statement of the title of a security shall be such as clearly to identify the security even though
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there may be only one class; for example, “Class A Common Stock,” “$6 Convertible Preferred
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Stock,” “5% Debentures Due 1965,” etc.
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