FORM 5
Check box if no longer Form 3 Holdings Reported Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
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OMB APPROVAL |
OMB
Number: 3235-0362 |
1. Name and Address
of Reporting Person * Sullivan Douglas B. (Last) (First) (Middle)
(Street)
(City) (State) (Zip) |
2. Issuer Name and Ticker
3. I.R.S.
Identification |
4. Statement for
Month/Year
5. If Amendment, Date
of |
6. Relationship of
Reporting Person(s) to Issuer |
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Director |
10% Owner |
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Executive Vice President - Development |
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7. Individual or Joint/Group Reporting
X Form Filed by One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of |
2. Transaction
Date |
2A. Deemed |
3. Transaction |
4. Securities Acquired (A) |
5. Amount of |
6. Owner- |
7. Nature of |
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Amount |
(A) or (D) |
Price |
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Common Stock |
9/16/02 |
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G |
500 |
D |
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1,500 |
D |
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* If the form is filed by more than one reporting person, see instruction 4(b)(v).
Table II -
Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Derivative
Security |
2. Conver sion or Exercise Price of Derivative Security |
3. Transaction Date |
3A. Deemed Execution Date,
if any (Month/ |
4. Transaction Code |
5. Number of Derivative
Securities Acquired (A) or Disposed of (D) |
6. Date Exercisable and
Expiration Date |
7. Title and Amount of
Underlying Securities |
8. Price of Derivative
Security |
9. Number of Derivative
Securities Beneficially Owned at End of Year |
10.Ownership of Derivative
Security: |
11. Nature of Indirect
Beneficial Ownership |
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(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
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Explanation of Responses:
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/s/ Douglas B. Sullivan ** Signature of Reporting Person |
March 13, 2003 Date |
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Douglas B. Sullivan |
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** |
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
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See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
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Note: |
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File three copies of this Form, one of which must be manually signed. |
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If space provided is insufficient, see Instruction 6 for procedure. |
Potential persons who are to respond to the collection of information in this form are not required to respond unless the form displays a currently valid OMB Number.
http://www.sec.gov/divisions/corpfin/forms/form5.htm
Last update: 09/03/2002