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Scott M Quist

Filed: 3 Feb 22, 7:55pm
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
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OMB Number: 3235-0362
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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 SCOTT M

(Last) (First) (Middle)
7 WANDERWOOD WAY

(Street)
SANDY UT 84092

(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 X 10% Owner
X Officer (give title below) Other (specify below)
Board Chair, Pres, CEO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/03/2021
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 C Common Stock 12/01/2021 M 104,656 A $5.83 104,656 D
Class A Common Stock 12/29/2021 J(1) 69,177 A $5.83 173,833 D
Class C Common Stock 12/29/2021 J(2) 69,177 D $5.83 104,656 D
Class A Common Stock 12/29/2021 M 69,177 D $5.83 35,479 D
Class C Common Stock 12/29/2021 S 13,837 D $8.81 21,642 D
Class C Common Stock 12/29/2021 G 21,642 D $5.83 0 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) $5.83(3) 12/02/2016 M 104,656(3) 03/02/2017 12/02/2021 Class C Common Stock 104,656(3) $5.83(3) 0(3) D
Employee Stock Option (right to buy) $4.42(4) 12/01/2017 A 93,443(4) 03/01/2018 12/01/2022 Class A Common Stock 93,443(4) $4.42(4) 93,443(4) D
Employee Stock Option (right to buy) $5.07(5) 11/30/2018 A 83,059(5) 02/28/2019 11/30/2023 Class A Common Stock 83,059(5) $5.07(5) 83,059(5) D
Employee Stock Option (right to buy) $5.04(6) 12/06/2019 A 56,504(6) 03/06/2020 12/06/2024 Class C Common Stock 56,504(6) $5.04(6) 56,504(6) D
Employee Stock Option (right to buy) $3.66(7) 03/27/2020 A 53,813(7) 06/27/2020 03/27/2025 Class C Common Stock 53,813(7) $3.66(7) 53,813(7) D
Employee Stock Option (right to buy) $9.48(8) 12/03/2021 A 50,000(8) 03/03/2022 12/03/2026 Class C Common Stock 50,000(8) $9.48(8) 50,000(8) D
Explanation of Responses:
1. Pursuant to an exchange of shares of Class A Common Stock from the George R. and Shirley C. Quist Family Partnership Ltd. (the "Family Partnership") to the reporting person.
2. Pursuant to an exchange of shares of Class C Common Stock from the reporting person to the Family Partnership.
3. This option was granted on December 2, 2016 as an option for either 80,000 shares of Class A Common Stock at an exercise price of $7.73 per share or 80,000 shares of Class C Common Stock at an exercise price of $7.73 per share, or any combination thereof. This option reflects the reporting person's election to have an option for 80,000 shares of Class C Common Stock at an exercise price of $7.73 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; a 2 1/2% stock dividend paid on July 17, 2020, and a 5% stock dividend paid on July 16, 2021.
4. This option was granted on December 1, 2017 as an option for 75,000 shares of Class A Common Stock at an exercise price of $5.56 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 2, 2018, February 1, 2019, and February 7, 2020; a 2 1/2% stock dividend paid on July 17, 2020, and a 5% stock dividend paid on July 16, 2021.
5. This option was granted on November 30, 2018 as an option for 70,000 shares of Class A Common Stock at an exercise price of $6.07 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 1, 2019, a 2 1/2% stock dividend paid on July 17, 2020, and a 5% stock dividend paid on July 16, 2021.
6. This option was granted on December 6, 2019 as an option for either 50,000 shares of Class A Common Stock at an exercise price of $6.01 per share or 50,000 shares of Class C Common Stock at an exercise price of $6.01 per share, or any combination thereof. This option reflects the reporting person's election to have an option for 50,000 shares of Class C Common Stock at an exercise price of $6.01 per share, but adjusted pursuant to the anti-dilution provisions of the 2013 Stock Option Plan to reflect 5% stock dividends paid on February 3, 2017, February 2, 2018, February 1, 2019, and February 7, 2020; a 2 1/2% stock dividend paid on July 17, 2020, and a 5% stock dividend paid on July 16, 2021.
7. This option was granted on March 27, 2020 as an option for either 50,000 shares of Class A Common Stock at an exercise price of $4.16 per share or 50,000 shares of Class C Common Stock at an exercise price of $4.16 per share, or any combination thereof. This option reflects the reporting person's election to have an option for 50,000 shares of Class C Common Stock at an exercise price of $4.16 per share, a 2 1/2% stock dividend paid on July 17, 2020, and a 5% stock dividend paid on July 16, 2021.
8. This option was granted on December 3, 2021 as an option for either 50,000 shares of Class A Common Stock at an exercise price of $9.48 per share or 50,000 shares of Class C Common Stock at an exercise price of $9.48 per share, or any combination thereof. This option reflects the reporting person's election to have an option for 50,000 shares of Class C Common Stock at an exercise price of $9.48 per share. The option vests in four quarterly installments of Class C Common Stock, beginning on March 3, 2022, until such shares are fully vested.
/s/ Scott M. Quist 02/03/2022
** Signature of Reporting Person Date
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