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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 | ||||||||
Stock Option (Right to Buy) | $ 6.16 | 11/08/2005 | M | 10,000 | 11/08/2006(1) | 11/08/2010 | common stock | 10,000 | $ 0 | 10,000 (2) (3) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
FRASER JEFFERY S C/O NIC INC. 10540 SOUTH RIDGEVIEW ROAD OLATHE, KS 66061 |
X | X | Chairman & CEO |
Stephen M. Kovzan, Attorney-in-Fact | 02/09/2006 | |
**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) | The option is exercisable in four equal annual installments, beginning on November 8, 2006. |
(2) | The Reporting Person also indirectly owns 21,450,805 shares of NIC Inc. common stock, which are held directly by the National Information Consortium Voting Trust, for which the Reporting Person and Ross C. Hartley act as trustees. Of this amount, the Reporting Person indirectly owns 1,023,251 shares held directly by the Voting Trust for the benefit of a trust, of which the Reporting Person is the beneficiary, and 4,401,405 shares held directly by the Voting Trust for the benefit of entities of which the Reporting Person acts as manager; however, the Reporting Person disclaims beneficial ownership over 1,852,717 of the shares held by one entity. |
(3) | The Reporting Person also directly owns 301,931 shares of NIC common stock and the following employee stock options to purchase NIC common stock: (i) 77,043 shares at $2.57 per share, all of which are currently exercisable, (ii) 150,000 shares at $3.34 per share, exercisable in four equal annual installments, beginning August 1, 2004, (iii) 20,000 shares at $7.67 per share, all of which are currently exercisable (correction to Form 4 as originally filed), and (iv) 25,000 shares at $4.15 per share, exercisable in four equal annual installments, beginning on November 5, 2005. |