4 1 e-6837.txt FORM 4 OF JOHN M. DAVIES ------ ------------------------------------- FORM 4 OMB APPROVAL ------ ------------------------------------- [ ] Check this box if no longer OMB Number 3235-0287 subject to Section 16. Form 4 Expires: December 31, 2001 or Form 5 obligations may Estimated average burden continue. See Instruction 1(b). hours per response............. 0.5 ------------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 ================================================================================ 1. Name and Address of Reporting Person* Davies John M. -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Ulmer & Berne LLP, 1300 East 9th Street, Suite 900 -------------------------------------------------------------------------------- (Street) Cleveland Ohio 44114-1583 -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Frontier Adjusters of America, Inc. (FAJ) ================================================================================ 3. IRS Or Social Security Number of Reporting Person (Voluntary) ================================================================================ 4. Statement for Month/Year May 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) President, CEO and Chairman of the Board ---------------------------------------- ================================================================================ 7. Individual or Joint/Group Filing (Check Applicable Line) [X] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person ================================================================================ Form 4 (continued)

========================================================================================================================= TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ========================================================================================================================= 1.Title of ~~Security~~ 2. Trans- 5. Amount of 6. Owner- Security action 3. Trans- 4. Securities Acquired (A) ~~5.Amount~~Securities ofship ~~6.Owner- 7.Nature of~~ (Instr. 3) ~~action~~Date action or Disposed of (D) ~~Securities~~Beneficially ~~ship~~Form: ~~Indirect~~7. ~~Date~~Nature of (Month/ Code (Instr. 3, 4 and 5) ~~Beneficially~~Owned ~~Form:~~at ~~Beneficial~~Direct ~~(Month~~Indirect Day/ (Instr. 8) ~~Owned at Direct Owner~~- ~~Day/~~ ---------- -----------~~-----------~~ End of Month (D) or ~~ship~~Beneficial Year) ---------- (A) or (Instr. 3 and 4) Indirect I) ~~(Instr.~~Ownership 4) Code V Amount (D) Price (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------- Common Stock 115/272/002001 P 12,~~300~~629,257 A $1~~,872~~.0058 2,629,757(1)(2) D and I By Merrymeeting, Inc. ------------------------------------------------------------------------------------------------------------------------- ~~Common Stock 11/28/00 P 10,500 A 20,036.10 11,800(2) D~~ ------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------- ========================================================================================================================= ========================================================================================================================= Table II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) =========================================================================================================== 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Derivative Security (Instr. 3) sion or action tion Securities Acquired Exercise Date Code (A) or Disposed Price of (Month/ (Instr. 8) of (D)(Instr. 3,4, and 5) Derivative Day/ ----------- ------------------------- Security Year) Code V (A) (D) ----------------------------------------------------------------------------------------------- ------------ ----------------------------------------------------------------------------------- ------------------------ ----------------------------------------------------------------------- ------------------------------------~~-----------------------------------------------------------~~ =========================================================================================================== 6. Date ~~Exer-~~Exercisable 9. Number and Expiration 7. Title and Amount of ~~8.Price~~of ~~9.Number~~Derivative 10.~~Owner-~~ ~~11.~~Ownership ~~Nature~~Date ~~cisable~~(Month/ ~~and~~ Underlying Securities ofative ofForm ~~Deriv- ship~~ of ~~Expiration~~Day/Year) (Instr. 3 and 4) ~~Deriv- ative Form of Indirect Date (Month/ ative~~ Securities ~~Deriv-~~Derivative ~~Benefi-~~11. ~~Day/Year)~~Nature ~~Security~~of ~~Bene~~- ~~ative cial~~ ---------------- -------------------- ~~(Instr~~8.5) ~~ficially~~Price of Beneficially Security: ~~Owner-~~Indirect Date Expira- ~~Title~~ Amount or Derivative Owned at Direct (D) ~~ship~~Beneficial Exer- tion Number of Security End of Month or Indirect ~~(Instr.4)~~Ownership cisable Date Title Shares (Instr.5) (Instr. 4) (I)(Instr.4) (Instr.4) ----------------------------------------------------------------------------------------------- ------------ ----------------------------------------------------------------------------------- ------------------------ ----------------------------------------------------------------------- ------------------------------------~~-----------------------------------------------------------~~ ===========================================================================================================

---------- (1) The Reporting Person is a 50% shareholder of MMI, which owns 5,258,513 shares of Frontier. This amount includes only 2,629,257 shares, or 50%, of the Frontier shares held by Merrymeeting, Inc. The Reporting Person disclaims any beneficial interest in the other 2,629,256 shares of Frontier held by Merrymeeting, Inc., which are not included in Item No. 5 above. This report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. (2) Includes 500 shares held directly by the Reporting Person. Explanation of Responses: /s/ John M. Davies May 15, 2001 ------------------------------- ----------------- **Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

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