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<TITLE>COTTON STATES LIFE INSURANCE COMPANY</TITLE>
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<H5 align="left" style="page-break-before:always"><A HREF="#toc">Table of Contents</A></H5><P>

<P align="center"><FONT size="2">As filed with the Securities and
Exchange Commission on November&nbsp;25, 2003
</FONT>

<P align="right"><FONT size="2">Registration No. _________
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<P align="center"><FONT size="4"><B>SECURITIES AND EXCHANGE COMMISSION</B>
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<div align="center"><FONT size="3"><B>Washington, D.C. 20549</B>
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<P align="center"><FONT size="5"><B>FORM S-8</B>
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<P align="center"><FONT size="5"><B>COTTON STATES LIFE INSURANCE COMPANY</B>
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<div align="center"><FONT size="2">(Exact name of issuer as specified in its charter)</FONT>
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    <TD width="47%">&nbsp;</TD>
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    <TD align="center" valign="top"><FONT size="2"><B>Georgia</B><BR>
(State or other jurisdiction of<BR>
incorporation or organization)</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="center" valign="top"><FONT size="2">
<B>58-0830929</B><BR>
(I.R.S. Employer<BR>
Identification No.)</FONT></TD>
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    <TD><FONT size="2">&nbsp;</FONT></TD>
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    <TD align="center" valign="top"><FONT size="2"><B>244 Perimeter Center Parkway, N.E.<BR>
Atlanta, Georgia</B><BR>
(Address of principal executive offices)</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="center" valign="top"><FONT size="2">
<B>30346</B><BR>
(Zip Code)</FONT></TD>
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<P align="center"><FONT size="2"><B>COTTON STATES LIFE INSURANCE COMPANY<BR>
1995 PERFORMANCE SHARE AWARDS PLAN</B><BR>
(Full title of the plan)
</FONT>

<P align="center"><FONT size="2"><B>Wendy Chamblee<BR>
Vice President and Corporate Secretary<BR>
Cotton States Life Insurance Company<BR>
244 Perimeter Center Parkway, N.E.<BR>
Atlanta, Georgia 30346<BR>
(770)&nbsp;391-8600</B><BR>
(Name, address and telephone number, including area code, of agent for service)
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<div align="center"><FONT size="2"><B>CALCULATION OF REGISTRATION FEE</B>
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    <TD nowrap align="center" colspan="3"><FONT size="1"><B>Proposed maximum</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>Proposed</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>&nbsp;</B></FONT></TD>
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    <TD nowrap align="center"><FONT size="1"><B>Title of each class of</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center"><FONT size="1"><B>Amount to be</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>offering price per</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>maximum aggregate</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>Amount of</B></FONT></TD>
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    <TD nowrap align="center"><FONT size="1"><B>securities to be registered(1)</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center"><FONT size="1"><B>registered(1)(2)(3)</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>share(3)</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center" colspan="3"><FONT size="1"><B>offering
price(3)</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>

<TD nowrap align="center" colspan="3"><FONT size="1"><B>registration</B></FONT></TD>
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    <TD valign="top"><FONT size="2">Common Stock, $1.00 par value</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
250,000 shares
</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD nowrap align="right" valign="top"><FONT size="2">$<br>
</FONT></TD>
    <TD align="right" valign="top"><FONT size="2">17.64<br>
</FONT></TD>
    <TD nowrap valign="top"><FONT size="2"><br>
</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD nowrap align="right" valign="top"><FONT size="2">$<br>
</FONT></TD>
    <TD align="right" valign="top"><FONT size="2">4,410,000<br>
</FONT></TD>
    <TD nowrap valign="top"><FONT size="2"><br>
</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD nowrap align="right" valign="top"><FONT size="2">$<br>
</FONT></TD>
    <TD align="right" valign="top"><FONT size="2">357<br>
</FONT></TD>
    <TD nowrap valign="top"><FONT size="2"><br>
</FONT></TD>
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      <TD width="1%" nowrap align="right"><FONT size="2">(1)
</FONT></TD>
    <TD width="2%"><FONT size="2">&nbsp;</FONT></TD>
    <TD width="97%"><FONT size="2">Pursuant to General Instruction E
of Form S-8, this Registration Statement covers the registration of
250,000 shares of Common Stock in addition to shares previously
registered under Registration Statement Number 333-00795.
</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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      <TD width="1%" nowrap align="right"><FONT size="2">(2)
</FONT></TD>
    <TD width="2%"><FONT size="2">&nbsp;</FONT></TD>
    <TD width="97%"><FONT size="2">Pursuant to Rule 416(a) under the Securities Act of 1933, as amended (the
&#147;1933 Act&#148;), this Registration Statement also covers an indeterminate
number of additional shares that may be offered and issued to prevent
dilution resulting from stock splits, stock dividends or similar
transactions as provided in the Cotton States Life Insurance Company 1995
Performance Share Awards Plan (the &#147;Plan&#148;).
</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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      <TD width="1%" nowrap align="right"><FONT size="2">(3)
</FONT></TD>
    <TD width="2%"><FONT size="2">&nbsp;</FONT></TD>
    <TD width="97%"><FONT size="2">Estimated solely for the purpose
of calculating the registration fee, in accordance with Rule
457(h)(1) under the 1933 Act, on the basis of the average of the high
and low prices of $17.74 and $17.53 per share for the Common Stock as
reported in the Nasdaq National Market System on November 21, 2003.
Cotton States Life Insurance Company (the &#147;Company&#148;) previously filed a
Registration Statement on Form S-8 on August&nbsp;24, 1989 (Registration No.
033-30696) which registered shares (such shares together with the
additional shares that have been offered and issued by the Company to
prevent dilution resulting from stock splits are referred to herein as the
&#147;ISO Plan Shares&#148;) to be offered pursuant to the Cotton States Life
Insurance Company 1983 Incentive Stock Option Plan (the &#147;ISO Plan&#148;). At
the annual meeting of the shareholders of the Company held on April&nbsp;28,
2003, a majority of the shareholders of the Company voted for a proposal
to transfer 250,000 of the ISO Plan Shares (the &#147;Transferred Shares&#148;) to
the Plan. The Transferred Shares are being registered pursuant to this
Registration Statement. The Company has filed on November 24, 2003 a
post-effective amendment to Registration Statement No.&nbsp;033-30696 which
deregisters the Transferred Shares.
</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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      <TD width="1%" nowrap align="right"><FONT size="2">
</FONT></TD>
    <TD width="2%"><FONT size="2">&nbsp;</FONT></TD>
    <TD width="97%"><FONT size="2">As permitted by Rule 429 under the
1933 Act, the prospectus related to this Registration Statement also
covers securities registered under Registration Statement Number
333-00795.
</FONT></TD>
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<P align="center"><FONT size="2">&nbsp;
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<A name="toc"><DIV align="CENTER" style="page-break-before:always"><U><B>TABLE OF CONTENTS</B></U></DIV></A>

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<TR><TD colspan="9"><A HREF="#000">Part II &#151; Information Required in the Registration Statement</A></TD></TR>
<TR><TD colspan="9"><A HREF="#001">SIGNATURES</A></TD></TR>
<TR><TD colspan="9"><A HREF="g86064aexv23w1.htm">EX-23.1 CONSENT OF ERNST & YOUNG LLP</A></TD></TR>
<TR><TD colspan="9"><A HREF="g86064aexv23w2.htm">EX-32.2 CONSENT OF KPMG LLP</A></TD></TR>
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<DIV align="left"><A NAME="000"></A></DIV>
<P align="center"><FONT size="2"><B>Part II &#151; Information Required in the Registration Statement</B>
</FONT>

<P align="left"><FONT size="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;This Registration Statement on Form S-8 is being filed to register the
Transferred Shares under the Plan. As discussed in Note (3)&nbsp;above, the Transferred Shares have
previously been registered under the ISO Plan on a Registration Statement on
Form S-8 (Registration No.&nbsp;033-30696, filed August&nbsp;24,
1989). This Registration Statement covers the registration of 250,000
shares of Common Stock in addition to shares previously registered
under Registration Statement Number 333-00795 (the &#147;Original
S-8&#148;). Pursuant to and as permitted by General Instruction E to Form S-8, the
contents of the Original S-8 are hereby incorporated by reference herein, and
the consents listed at Item&nbsp;8 below are annexed hereto.
</FONT>
<P align="left"><FONT size="2"><B>Item&nbsp;8</B>. <B>Exhibits</B>.
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    <TD nowrap align="left"><FONT size="1"><B>Exhibit No.</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD nowrap align="center"><FONT size="1"><B>Description</B></FONT></TD>
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    <TD valign="top"><FONT size="2">23.1</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
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Consent of Ernst &#038; Young LLP.</FONT></TD>
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    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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    <TD valign="top"><FONT size="2">23.2</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
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Consent of KPMG LLP.</FONT></TD>
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    <TD valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
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    <TD valign="top"><FONT size="2">24</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
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Powers of Attorney (contained on the signature page hereof).</FONT></TD>
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<P align="center"><FONT size="2">3
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<DIV align="left"><A NAME="001"></A></DIV>
<P align="center"><FONT size="2">SIGNATURES
</FONT>

<P align="left"><FONT size="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Pursuant to the requirements of the Securities Act of 1933, as amended
(the &#147;1933 Act&#148;), the registrant certifies that it has reasonable grounds to
believe that it meets all of the requirements for filing on Form S-8 and has
duly caused this Registration Statement to be signed on its behalf by the
undersigned, thereunto duly authorized, in the City of Atlanta, Georgia, on
this 24th day of November, 2003.
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    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD colspan="3" align="left" valign="top"><FONT size="2"><B>Cotton States Life Insurance Company</B></FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
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By:
</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">/s/ J. Ridley Howard<BR>
</FONT><HR size="1" noshade><FONT size="2">
J. Ridley Howard<BR>
Chairman of the Board of Directors, President<BR>
and Chief Executive Officer</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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By:
</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">/s/ William J. Barlow<BR>
</FONT><HR size="1" noshade><FONT size="2">
William J. Barlow<BR>
Vice President of Finance and Assistant Treasurer<BR>
(Principal Financial and Accounting Officer)</FONT></TD>
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<P align="center"><FONT size="2">POWER OF ATTORNEY
</FONT>

<P align="left"><FONT size="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature
appears below constitutes and appoints J. Ridley Howard and Harry Scott,
jointly and severally, such person&#146;s attorneys-in-fact, each with the power of
substitution, for such person in any and all capacities to sign any amendments
to this Registration Statement on Form S-8, and to file the same, with exhibits
thereto, and other documents in connection therewith, with the Securities and
Exchange Commission, hereby ratifying and confirming all that each of said
attorneys-in-fact, or his substitute or substitutes, may do or cause to be done
by virtue hereof.
</FONT>
<P align="left"><FONT size="2">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Pursuant to the requirements of the 1933 Act, this Registration Statement
has been signed by the following persons in the capacities indicated below on
this 24th day of November, 2003.
</FONT>
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    <TD nowrap align="center"><FONT size="1"><B>Title</B></FONT></TD>
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    <TD width="70%">&nbsp;</TD>
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    <TD width="25%">&nbsp;</TD>
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    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Carol D. Cherry<BR>
</FONT><HR size="1" noshade><FONT size="2">
Carol D. Cherry</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Gaylord O. Coan<BR>
</FONT><HR size="1" noshade><FONT size="2">
Gaylord O. Coan</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>

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    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
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    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Thomas A. Harris<BR>
</FONT><HR size="1" noshade><FONT size="2">
Thomas A. Harris</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">/s/ J. Ridley Howard<BR>
</FONT><HR size="1" noshade><FONT size="2">
J. Ridley Howard</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
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    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
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    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Robert C. McMahan<BR>
</FONT><HR size="1" noshade><FONT size="2">
Robert C. McMahan</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
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<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Darrell D. Pittard<BR>
</FONT><HR size="1" noshade><FONT size="2">
Darrell D. Pittard</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">/s/ Mathews D. Swift<BR>
</FONT><HR size="1" noshade><FONT size="2">
Mathews D. Swift</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
</TR>

<TR><TD><FONT size="2">&nbsp;</FONT></TD></TR>
<TR valign="bottom">
    <TD align="center" nowrap valign="top"><FONT size="2">/s/ E. Jenner Wood, III<BR>
</FONT><HR size="1" noshade><FONT size="2">
E. Jenner Wood, III</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Director</FONT></TD>
</TR>
</TABLE>
</DIV>

<P align="center"><FONT size="2">4
</FONT>
<!-- PAGEBREAK -->
<P><HR noshade><P>
<H5 align="left" style="page-break-before:always"><A HREF="#toc">Table of Contents</A></H5><P>
<P align="center"><FONT size="2"><B>Exhibit&nbsp;Index</B>
</FONT>

<DIV align="center">
<TABLE cellspacing="0" border="0" cellpadding="0" width="65%">
<TR valign="bottom">
    <TD width="10%">&nbsp;</TD>
    <TD width="5%">&nbsp;</TD>
    <TD width="85%">&nbsp;</TD>
</TR>
<TR  valign="bottom">
    <TD nowrap align="left"><FONT size="1"><B>Exhibit</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
</TR>
<TR  valign="bottom">
    <TD nowrap align="left"><FONT size="1"><B>Number</B></FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
</TR>
<TR  valign="bottom">
    <TD nowrap align="left"><HR size="1" noshade></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
    <TD><FONT size="1">&nbsp;</FONT></TD>
</TR>
<TR valign="bottom">
    <TD valign="top"><FONT size="2">23.1</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Consent of Ernst &#038; Young LLP.</FONT></TD>
</TR>

<TR valign="bottom">
    <TD valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
</TR>

<TR valign="bottom">
    <TD valign="top"><FONT size="2">23.2</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Consent of KPMG LLP.</FONT></TD>
</TR>

<TR valign="bottom">
    <TD valign="top"><FONT size="2">&nbsp;</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">&nbsp;</FONT></TD>
</TR>

<TR valign="bottom">
    <TD valign="top"><FONT size="2">24</FONT></TD>
    <TD><FONT size="2">&nbsp;</FONT></TD>
    <TD align="left" valign="top"><FONT size="2">
Powers of Attorney (contained on the signature page hereof).</FONT></TD>
</TR>
</TABLE>
</DIV>

<P align="center"><FONT size="2">&nbsp;
</FONT>
</BODY>
</HTML>
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{"company-data": {"conformed-name": "COTTON STATES LIFE INSURANCE CO /", "cik": "0000025118", "assigned-sic": "6311", "irs-number": "580830929", "state-of-incorporation": "GA", "fiscal-year-end": "1231"}, "filing-values": {"form-type": "S-8", "act": "33", "file-number": "333-110738", "film-number": "031022748"}, "business-address": {"street1": "244 PERIMETER CENTER PKWY NE", "city": "ATLANTA", "state": "GA", "zip": "30346", "phone": "4043918600"}, "mail-address": {"street1": "P.O. BOX 15303", "city": "ATLANTA", "state": "GA", "zip": "30348"}, "former-company": {"former-conformed-name": "COTTON STATES LIFE & HEALTH INSURANCE CO", "date-changed": "19920703"}}
COTTON STATES LIFE INSURANCE COMPANY
Table of Contents
As filed with the Securities and
Exchange Commission on November 25, 2003
Registration No. _________
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM S-8
COTTON STATES LIFE INSURANCE COMPANY
(Exact name of issuer as specified in its charter)
Georgia
(State or other jurisdiction of
incorporation or organization)
58-0830929
(I.R.S. Employer
Identification No.)
244 Perimeter Center Parkway, N.E.
Atlanta, Georgia
(Address of principal executive offices)
30346
(Zip Code)
COTTON STATES LIFE INSURANCE COMPANY
1995 PERFORMANCE SHARE AWARDS PLAN
(Full title of the plan)
Wendy Chamblee
Vice President and Corporate Secretary
Cotton States Life Insurance Company
244 Perimeter Center Parkway, N.E.
Atlanta, Georgia 30346
(770) 391-8600
(Name, address and telephone number, including area code, of agent for service)
CALCULATION OF REGISTRATION FEE
Proposed maximum
Proposed
Title of each class of
Amount to be
offering price per
maximum aggregate
Amount of
securities to be registered(1)
registered(1)(2)(3)
share(3)
offering
price(3)
registration
Common Stock, $1.00 par value
250,000 shares
$
17.64
$
4,410,000
$
357
(1)
Pursuant to General Instruction E
of Form S-8, this Registration Statement covers the registration of
250,000 shares of Common Stock in addition to shares previously
registered under Registration Statement Number 333-00795.
(2)
Pursuant to Rule 416(a) under the Securities Act of 1933, as amended (the
"1933 Act"), this Registration Statement also covers an indeterminate
number of additional shares that may be offered and issued to prevent
dilution resulting from stock splits, stock dividends or similar
transactions as provided in the Cotton States Life Insurance Company 1995
Performance Share Awards Plan (the "Plan").
(3)
Estimated solely for the purpose
of calculating the registration fee, in accordance with Rule
457(h)(1) under the 1933 Act, on the basis of the average of the high
and low prices of $17.74 and $17.53 per share for the Common Stock as
reported in the Nasdaq National Market System on November 21, 2003.
Cotton States Life Insurance Company (the "Company") previously filed a
Registration Statement on Form S-8 on August 24, 1989 (Registration No.
033-30696) which registered shares (such shares together with the
additional shares that have been offered and issued by the Company to
prevent dilution resulting from stock splits are referred to herein as the
"ISO Plan Shares") to be offered pursuant to the Cotton States Life
Insurance Company 1983 Incentive Stock Option Plan (the "ISO Plan"). At
the annual meeting of the shareholders of the Company held on April 28,
2003, a majority of the shareholders of the Company voted for a proposal
to transfer 250,000 of the ISO Plan Shares (the "Transferred Shares") to
the Plan. The Transferred Shares are being registered pursuant to this
Registration Statement. The Company has filed on November 24, 2003 a
post-effective amendment to Registration Statement No. 033-30696 which
deregisters the Transferred Shares.
As permitted by Rule 429 under the
1933 Act, the prospectus related to this Registration Statement also
covers securities registered under Registration Statement Number
333-00795.
TABLE OF CONTENTS
Part II — Information Required in the Registration Statement
SIGNATURES
EX-23.1 CONSENT OF ERNST & YOUNG LLP
EX-32.2 CONSENT OF KPMG LLP
Table of Contents
Part II — Information Required in the Registration Statement
This Registration Statement on Form S-8 is being filed to register the
Transferred Shares under the Plan. As discussed in Note (3) above, the Transferred Shares have
previously been registered under the ISO Plan on a Registration Statement on
Form S-8 (Registration No. 033-30696, filed August 24,
1989). This Registration Statement covers the registration of 250,000
shares of Common Stock in addition to shares previously registered
under Registration Statement Number 333-00795 (the "Original
S-8"). Pursuant to and as permitted by General Instruction E to Form S-8, the
contents of the Original S-8 are hereby incorporated by reference herein, and
the consents listed at Item 8 below are annexed hereto.
Item 8
.
Exhibits
.
Exhibit No.
Description
23.1
Consent of Ernst & Young LLP.
23.2
Consent of KPMG LLP.
24
Powers of Attorney (contained on the signature page hereof).
3
Table of Contents
SIGNATURES
Pursuant to the requirements of the Securities Act of 1933, as amended
(the "1933 Act"), the registrant certifies that it has reasonable grounds to
believe that it meets all of the requirements for filing on Form S-8 and has
duly caused this Registration Statement to be signed on its behalf by the
undersigned, thereunto duly authorized, in the City of Atlanta, Georgia, on
this 24th day of November, 2003.
Cotton States Life Insurance Company
By:
/s/ J. Ridley Howard
J. Ridley Howard
Chairman of the Board of Directors, President
and Chief Executive Officer
By:
/s/ William J. Barlow
William J. Barlow
Vice President of Finance and Assistant Treasurer
(Principal Financial and Accounting Officer)
POWER OF ATTORNEY
KNOW ALL PERSONS BY THESE PRESENTS, that each person whose signature
appears below constitutes and appoints J. Ridley Howard and Harry Scott,
jointly and severally, such person's attorneys-in-fact, each with the power of
substitution, for such person in any and all capacities to sign any amendments
to this Registration Statement on Form S-8, and to file the same, with exhibits
thereto, and other documents in connection therewith, with the Securities and
Exchange Commission, hereby ratifying and confirming all that each of said
attorneys-in-fact, or his substitute or substitutes, may do or cause to be done
by virtue hereof.
Pursuant to the requirements of the 1933 Act, this Registration Statement
has been signed by the following persons in the capacities indicated below on
this 24th day of November, 2003.
Signature
Title
/s/ Carol D. Cherry
Carol D. Cherry
Director
/s/ Gaylord O. Coan
Gaylord O. Coan
Director
/s/ Thomas A. Harris
Thomas A. Harris
Director
/s/ J. Ridley Howard
J. Ridley Howard
Director
/s/ Robert C. McMahan
Robert C. McMahan
Director
/s/ Darrell D. Pittard
Darrell D. Pittard
Director
/s/ Mathews D. Swift
Mathews D. Swift
Director
/s/ E. Jenner Wood, III
E. Jenner Wood, III
Director
4
Table of Contents
Exhibit Index
Exhibit
Number
23.1
Consent of Ernst & Young LLP.
23.2
Consent of KPMG LLP.
24
Powers of Attorney (contained on the signature page hereof).