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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Common Stock Purchase Option | (3) | (3) | (3) | Common Stock | 76,190 (3) | 76,190 | D (4) | ||||||||
Common Stock Purchase Option | $ 10.9 | 11/07/2002 | 11/07/2011 | Common Stock | 125,000 | 125,000 | I | CK Partners (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KOPKO FREDERICK H JR 20 NORTH WACKER DRIVE SUITE 2520 CHICAGO, IL 60606 |
X | X |
Frederick H. Kopko | 12/01/2004 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Consists of (i)895,749 shares benefically owned by CK Partners; (ii) 267,064 shares owned by Joseph A. Czyzyk. CK Partners holds all Shares beneficially owned by Mr Kopko and Mr. Czyzkk (the" Partners"). Pursuant to Section 7 of the Partnership Agreement of CK Partners, the Partners have agreed that the Shares shall be voted for Mr. Czyzyk and Mr. Kopko, or as designated by Mr. Czyzyk and Mr. Kopko. |
(2) | Owned by Mr. Kopko but held and voted by CK Partners |
(3) | Consisting of (i) options to acquire 7,563 shares at $9.252 per share, exerciable as of 12/01/1994 and expire 12/01/2004,(ii)options to acquire 7,563 shares at $14.364 exerciable as of 03/21/1997 and expire 03/21/2006,(iii) options to acquire 7,563 shares at $11.40 exerciable as of 12/12/1997 and expire 12/12/2006,(iv)options to acquire 7,563 shares at $11.50 exerciable as of 12/04/1998 and expire 12/04/2007,(v)options to acquire 3,438 shares at $14.364 exerciable as of 03/21/1996 and expire 03/21/2006,(vi)options to acquire 5,000 shares at $15.50 exerciable as of 12/02/2000 and expire 12/02/2009, (vii)options to acquire 25,000 shares at $11.750 exerciable as of 11/01/2001 and expire 11/01/2010; (viii)options to acquire 5,000 shares at $10.50 exerciable as of 12/14/2001 and expire 12/14/2010;and (ix)options to acquire 7,500 shares at $10.90 exerciable as of 11/07/2002 and expire 11/07/2011. |
(4) | Owned by Mr. Kopko but held by CK Partners |
(5) | Consists of 125,000 shares issuable upon exercise of options owned by Mr. Joseph A. Czyzyk but held by CK Partners |