SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Form 11-K
(Mark One)
X ANNUAL REPORT PURSUANT TO SECTION 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934
For the fiscal year ended December 31, 2004
OR
TRANSACTION REPORT PURSUANT TO SECTION 15(d) OF THE SECURITIES
EXCHANGE ACT OF 1934
Commission file number 0-3722
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A. Full title of the plan and the address of the plan, if different from that of the issuer named below:
Atlantic American Corporation
401(k) Retirement Savings Plan
B. Name of issuer of the securities held pursuant to the plan and the address of its principal executive office:
Atlantic American Corporation
4370 Peachtree Road, N.E.
Atlanta, GA 30319
TABLE OF CONTENTS
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SIGNATURES
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Financial Statements and Schedules
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Consent of Gifford, Hillegass & Ingwersen, L.L.P.
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SIGNATURES
THE PLAN. Pursuant to the requirements of the Securities Exchange Act of 1934,
the trustees (or other persons who administer the employee benefit plan) have
duly caused this annual report to be signed on its behalf by the undersigned
hereunto duly authorized.
Atlantic American Corporation
401(k) Retirement Savings Plan
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(Name of Plan)
Date: June 30, 2005 /s/ John G. Sample, Jr.
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John G. Sample, Jr.
Senior Vice President and CFO
ATLANTIC AMERICAN CORPORATION
401(K) RETIREMENT SAVINGS PLAN
The following exhibits are filed herewith:
Exhibit 1: Financial Statements and Supplemental Information for
the years ended December 31, 2004 and 2003 together
with Report of Independent Registered Public
Accounting Firm.
Exhibit 2: Consent of Gifford , Hillegass & Ingwersen, L.L.P.
Independent Registered Public Accounting Firm.