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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 | ||||||||
Convertible 5.5% Notes | $ 15 | 09/30/2009 | S | $ 9,450 | 10/27/2005(4) | 10/15/2010 | Common Stock | 1,400 | $ 21,000 | 0 | I | Shared discretionary voting power. |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
NEIBOER SCOTT 104 WOODMONT BLVD SUITE 200 NASHVILLE, TN 37205 |
resigned as director |
/s/ R. Scott Nieboer | 10/02/2009 | |
**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) | Ditribution from limited partnership to limited partners and general partner |
(2) | The shares were distributed in a pro rata distribution to the limited partners and general partner of Trace Partners, L.P. on September 30, 2009 |
(3) | Of these beneficially owned shares, 190,188 are owned by his wife. There is no shared voting or dispospositive power with regards to these 190,188 shares. |
(4) | This was the issue date. Derivative securities were exercisable at any time. |