SEC 1473 |
Potential persons who are to 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. |
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
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OMB APPROVAL |
OMB
Number: 3235-0104 |
(Print or Type Responses)
(Last) (First) (Middle)
(Street)
(City)
(State) (Zip) |
2.
Date of Event
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5. Relationship of Reporting Person(s) to Issuer (Check all applicable) |
6. If Amendment, / /
Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed
by More than One Reporting Person |
Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security |
2. Amount of |
3. Ownership Form: Direct (D) or Indirect (I) |
4. Nature of Indirect Beneficial Ownership |
Common stock |
600 |
D |
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Common stock |
26,520 |
I |
By Kosasa Foundation |
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Table II -
Derivative Securities Beneficially Owned |
1. Title of |
2. Date Exercisable and |
3. Title and Amount of |
4. Conversion or |
5. Ownership |
6. Nature of Indirect |
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Date Exercisable |
Expiration Date |
Title |
Amount
or |
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Option |
7/30/1998 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/1999 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2000 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2001 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2002 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2003 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2004 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2005 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2006 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Option |
7/30/2007 |
7/30/2007 |
Common stock |
3,000 |
8.9375 |
D |
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Reminder: Report on a separate
line for each class of securities beneficially owned directly or indirectly.
Explanation of Responses:
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/s/ Paul Kosasa |
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11/27/02 |
** Signature of Reporting Person |
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Date |
* |
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If the form is filed by more than one reporting person, see Instruction 5(b)(v). |
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** |
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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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Note: |
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File three copies of this Form, one of which must be manually signed. If space is insufficient, |
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See Instruction 6 for procedure. |
http://www.sec.gov/divisions/corpfin/forms/form3.htm
Last update: 09/03/2002