4 1 x125f4dor.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person: John A. Dore 222 N. LaSalle, Suite 1600 Chicago, Illinois 60601 U.S.A. 2. Issuer Name and Ticker or Trading Symbol: American Country Holdings Inc. ACHI 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement for Month/Year: November 2001 5. If Amendment, Date of Original (Month/Year): 6. Relationship of Reporting Person(s) to Issuer (Check all applicable): (x) Director (x) 10% Owner (x) Officer (give title below) ( ) Other (specify below): Chairman, President and Chief Executive Officer 7. 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

5. Amount of 2. Trans- Securities 6. Owner- action 3. Trans- Beneficially ship Form: 1. Title of Date action 4. Securities Acquired Owned at End Direct (D) or 7. Nature of Indirect Security (Month/ Code (A) or Disposed of (D) of Month Indirect (I) Beneficial Ownership (Instr. 3) Day/Year) (Instr. 8) (Instr. 3, 4 and 5) (Instr. 3 and 4) (Instr. 4) (Instr. 4) ----------- --------- ---------- ---------------------- ---------------- ------------- --------------------- Code V Amount (A)or(D) Price ---- - ------ -------- ----- Common ~~9/30/01 A 1,537 A $1.50~~ 507,231~~(1)~~ D Stock, $.01 par value Common 3,000 I IRA Stock, $.01 par value Common 4,000 I Keogh Stock, $.01 par value Common 211/19/01 A 600 A $1.24 3,~~700~~300 I As trustee for Stock, Christopher L. Dore $.01 par value Common 3,565 I As trustee for Stock, John A. Dore II $.01 par value ~~(1) Include 1,537 shares acquired under the employee stock purchase plan in September 2001.~~

Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)

Explanation of Responses: SIGNATURE OF REPORTING PERSON: /s/ John A. Dore ------------------------------ John A. Dore Dated: December 4, 2001

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