Form 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |
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Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b). |
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[ ] | Form 3 Holdings Reported | ||
[ ] | Form 4 Transactions Reported |
1. Name and Address of Reporting
Person*
Drack, Paul E. |
2. Issuer Name and Ticker
or Trading Symbol
Miller Industries, Inc. (MLR) |
6. Relationship of Reporting Person(s) to Issuer
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(Last) (First) (Middle)
8503 Hilltop Drive |
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Year 12-31-00 | ||||||||
(Street)
Ooltewah, TN 37363 |
5. If Amendment, Date of Original (Month/Year)
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7. Individual or Joint/Group Filing (Check Applicable Line) _X_ Form filed by One Reporting Person ___ Form filed by More than One Reporting Person | ||||||||
(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||
1. Title of Security (Instr. 3) |
2. Transaction Date (Month/Day/Year) |
2A. Deemed Execution Date, if any (Month/Day/Year) |
3. Transaction Code (Instr. 8) |
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned at the end of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount |
(A) or (D) |
Price | ||||||
* If the form is filed by more than one reporting person, see instruction 4(b)(v).
Form 5 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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. Trans- action 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 |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Year (Instr. 4) |
10. Ownership of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
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Stock Options |
$7.023 |
9/12/00 |
A5 |
11,148 |
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(1) |
9/12/10 |
Common Stock |
11,148 |
11,148 |
D |
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Stock Options |
$14.0825 |
10/18/99 |
A5 |
4,315 |
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(2) |
10/18/09 |
Common Stock |
4,315 |
4,315 |
D |
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Stock Options |
$27.0625 |
9/14/98 |
A5 |
3,168 |
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(3) |
9/14/08 |
Common Stock |
3,168 |
3,168 |
D |
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Explanation of
Responses:
(1) Options become exercisable in two equal installments on 3/12/01 and
3/12/02. |
/s/ Paul E. Drack Paul E. Drack **Signature of Reporting Person |
2-12-03
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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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure |