FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of |
Estimated average burden hours per response...1.0 |
|||
£ |
Check this box if no longer |
||||
£ |
Form 3 Holdings Reported |
||||
£ |
Form 4 Transactions Reported |
1. Name and Address of Reporting Person* |
2. Issuer Name and Tickler or Trading Symbol
|
6. Relationship of Reporting Person(s) to Issuer |
||||||||
|
Director |
|
10% Owner |
|||||||
X |
Officer (give title below) |
|
Other (specify below) |
|||||||
President of subsidiary |
||||||||||
(Last) (First) (Middle) |
3. I.R.S. Identification Number of |
4. Statement for Month/Year |
7. Individual or Joint/Group Filing (Check Applicable Line) |
|||||||
5. If Amendment, Date of |
X |
Form filed by One Reporting Person |
||||||||
(Street) |
|
Form filed by More than One Reporting Person |
||||||||
(City) (State) (Zip) |
Table I ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
|||||||||
1. Title of Security |
2. Transaction Date |
3. Transaction |
4. Securities Acquired (A) |
5. Amount of Securities |
6. OwnershipForm: Direct (D) or Indirect (I) (Instr. 4) |
7. Nature ofIndirect Beneficial Ownership (Instr. 4) |
||||
Amount |
(A) or |
Price |
||||||||
Common Stock |
4,325 |
I |
By 401(k) Trust |
|||||||
* 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 |
2. Conversion |
3. Transaction (Month/Day/Year) |
4. Transaction |
5. Number of |
6. Date Exercisable |
7. Title and Amount |
8. Price of |
9. Number of |
10. Ownership |
11. Nature of |
|||||
(A) |
(D) |
Date |
Expiration |
Title |
Amount or |
||||||||||
Employee Stock Option Plan |
|
|
|
12,000 |
|
|
Common Stock |
|
32,000 |
D |
|||||
Explanation of Responses: |
Cheryl C. Carter |
January 6, 2003 |
||||
**Signature of Reporting Person /s/ Cheryl C. Carter, Power of Attorney |
Date |
||||
|
|||||
** |
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. |