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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT 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 2270 (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 at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Stock Option | $ 6.545 | 05/03/2004 | Â | A | 4,000 | Â | 05/03/2005(3) | 05/03/2014 | Common Stock | $ 0 | 4,000 | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BEAM FRANCIS H JR 17417 BEECH GROVE TRAIL BAINBRIDGE, OH 44023 |
 X |  |  |  |
/s/ Aileen Liebertz, Attorney-in-Fact for Francis H. Beam, Jr. | 01/24/2005 | |
**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) | Held in Trust pursuant to Directors Deferred Compensation Plan for Non-Employee Directors - a 16b-3 Plan, as of December 31, 2004. Since reporting person's last report, 6,858 shares previously held by the Trust have been distributed and are now held directly. |
(2) | Adjusted to reflect the 6,858 shares described in Footnote (1). |
(3) | Grant pursuant to the Company's 1998 Incentive Equity Plan (As Amended and Restated as of April 30, 2004), a Rule 16b-3 plan, to the reporting person of an option to purchase 4,000 shares of the Company's Common Stock, 100% exercisable on and after May 3, 2005. |