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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MEHNEY DAVID P C/O 9341 COURTLAND DRIVE NE ROCKFORD, MI 49351 |
X |
/s/ Timothy E. Foley, by Power of Attorney | 04/13/2009 | |
**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) | Represents shares purchased pursuant to a broker-assisted dividend reinvestment program. |
(2) | The number of shares reported is adjusted to reflect the Stock Split. |
(3) | The number of shares reported as being beneficially owned by the Trust immediately following this transaction reflects (1) the number of shares beneficially owned by the Trust as of the date of this filing immediately after giving effect to this transaction and (2) the Stock Split, which occurred prior to this transaction and which the reporting person inadvertently did not account for in the Original Form 4 or the Form 4s that he filed on April 18, 2006 or April 2, 2007. Because the reporting person did not account for the Stock Split in the Original Form 4 or the Form 4s that he filed on April 18, 2006 or April 2, 2007, the number of shares reported in column 5 as being beneficially owned by the Trust immediately following the transactions reported in those Form 4s was understated by 12,812 shares. |
(4) | The number of shares reported as being beneficially owned directly by the reporting person immediately following this transaction accounts for the Stock Split and the 10 Additional Shares, both of which occurred prior to this transaction and which the reporting person inadvertently did not account for in the Original Form 4 or the Form 4s he filed on April 18, 2006 or April 2, 2007. Because the reporting person did not account for the Stock Split and the 10 Additional Shares in the Original Form 4 or the Form 4s that he filed on April 18, 2006 or April 2, 2007, the number of shares reported in column 5 as being beneficially owned directly by the reporting person immediately following the transactions reported in those Form 4s was understated by 21,240 shares. |
(5) | 2,250 of these shares are owned by the David P. and Linda M. Mehney Foundation. The reporting person disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein, and the inclusion of these shares in this Form 4 shall not be deemed an admission that the reporting person is the beneficial owner of these shares for purposes of Section 16 or for any other purpose. |
(6) | The number of shares reported as being beneficially owned by the Profit-Sharing Plan ("Profit Plan") immediately following the stock option exercise reported herein has been adjusted to account for the Stock Split, which occurred prior to this transaction and which the reporting person inadvertently did not account for in the Original Form 4 or the Form 4s he filed on April 18, 2006 or April 2, 2007. Because the reporting person did not account for the Stock Split in the Original Form 4 or the Form 4s that he filed on April 18, 2006 or April 2, 2007, the number of shares reported in column 5 as being beneficially owned by the Profit Plan immediately following the transactions reported in those Form 4s was understated by 11,812 shares. |
Remarks: This Form 4/A is being filed by the reporting person to amend a Form 4 filed by the reporting person on April 28, 2008 (the "Original Form 4") to (1) report several acquisitions of the Issuer's common stock through dividend reinvestments (the "Dividend Reinvestments") that occurred between November 2003 and August 2004 in respect of holdings by a trust (the "Trust") established for the benefit of the reporting person's great grandchildren of which the reporting person is co-trustee with his wife and (2) amend the Original Form 4 to adjust the number of shares beneficially owned by the reporting person following the stock option exercise reported therein and herein to account for (a) the shares acquired through the Dividend Reinvestments, (b) a 3-for-2 stock split (the "Stock Split") of the Issuer's common stock that occurred on February 1, 2005 and was not reflected in the share amounts reported in column 5 of the reporting person's Original Form 4 or the Form 4s filed on April 18, 2006 or April 2, 2007 and (c) 10 shares of the Issuer's common stock that the reporting person acquired in connection with the Stock Split due to a broker error (the "10 Additional Shares"). |