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pdfUNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
Check this box if no longer
subject to Section 16. Form 4 or
Form 5 obligations may continue.
See Instruction 1(b).
(Print or Type Responses)
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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(h) of the Investment Company Act of 1940
1. Name and Address of Reporting Person*
5. Relationship of Reporting Person(s) to Issuer
2. Issuer Name and Ticker or Trading Symbol
(Check all applicable)
(Last)
(First)
(Middle)
(Street)
(City)
1. Title of Security
(Instr. 3)
(State)
(Zip)
2. Trans
action
Date
(Month/
Day/
Year)
3. Date of Earliest
Transcaction Required
to be Reported
(Month/Day/Year)
4. If Amendment,
Date Original
Filed(Month/Day/Year)
Director
Officer (give
title below)
10% Owner
Other (specify
below)
6. Individual or Joint/Group Filing (Check Applicable Line)
__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
2A. Deemed 3. Trans
action
Execution
Date, if
Code
(Instr. 8)
any
(Month/
Day/Year)
Code
V
4. Securities Acquired (A)
or Disposed of (D)
(Instr. 3, 4 and 5)
Amount
(A) or
(D)
Price
6. Owner 7. Nature of
5. Amount of
Indirect
Securities
ship
Form:
Beneficial
Beneficially
Owner
Direct
Owned
ship
Following
(D) or
Indirect
Reported
(I)
Transaction (s)
(Instr. 4)
(Instr. 3 and 4)
(Instr. 4)
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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.
(Over)
SEC 1474 (01-05)
FORM 4 (continued)
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
Security
sion or
action
(Instr. 3)
Exercise Date
Price of
Deri
(Month/
vative Day/
Security Year)
3A.Deemed 4. Trans
5.
Execution
action
Date, if
Code
(Instr. 8)
any
(Month/
Day/
Year)
Number of Deriv
ative Securities Ac
quired (A) or Dis
posed of (D)
(Instr. 3, 4, and 5)
Date
Exer
cisable
Code V
(A)
8. Price 9. Number 10.Owner 11. Nature
of
of deriv
ship
of
Deriv
ative
Form of
Indirect
ative
Secur
Deriv
Benefi
Secur
ities
ative
cial
ity
Bene
Security:
Owner
(Instr.
ficially
Direct
ship
5)
Owned
(D) or
(Instr. 4)
follow
Indirect
ing
(I)
Re
(Instr. 4)
Amount or
ported
Number of
Transac
tion
Shares
(s)(Instr.
4)
7. Title and Amount of
6. Date Exer
Underlying Securities
cisable and
(Instr. 3 and 4)
Expiration
Date
(Month/Day/
Year)
(D)
Expira
tion
Date
Title
Explanation of Responses:
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
**Signature of Reporting Person
Date
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see Instruction 6 for procedure.
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 Number.
Page 2
File Type | application/pdf |
File Title | Form 4 |
Subject | Sec1474, Date.modified: 2011-01-04 |
Author | U.S. Securities and Exchange Commission |
File Modified | 2011-01-04 |
File Created | 2011-01-03 |