FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 06/30/2004 |
3. Issuer Name and Ticker or Trading Symbol
MONEYGRAM INTERNATIONAL INC [ MGI ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock(1) | 541,666.878 | D | |
Common Stock(1) | 5,779.1764 | I | by 401(k) Plan |
Common Stock(1) | 11,605 | I | by Family Trust |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Units(1) | (1) | (1) | Common Stock | 55,887.4047 | (1) | D | |
Option (right to buy)(1) | 08/18/1996 | 08/16/2004 | Common Stock | 36,889 | $9.3047 | D | |
Option (right to buy)(1) | 08/17/1997 | 08/15/2005 | Common Stock | 26,349 | $9.9369 | D | |
Option (right to buy)(1) | 08/16/1998 | 08/14/2006 | Common Stock | 45,000 | $10.5646 | D | |
Option (right to buy)(1) | 08/20/1999 | 08/19/2007 | Common Stock | 100,000 | $13.9671 | D | |
Option (right to buy)(1) | 05/12/2000 | 05/11/2008 | Common Stock | 70,000 | $18.8687 | D | |
Option (right to buy)(1) | 05/11/2001 | 05/10/2009 | Common Stock | 95,000 | $22.4616 | D | |
Option (right to buy)(1) | 02/18/2002 | 02/17/2010 | Common Stock | 120,000 | $18.6069 | D | |
Option (right to buy)(1) | 02/16/2003 | 02/15/2011 | Common Stock | 187,500 | $19.1875 | D | |
Option (right to buy)(1) | 11/16/2003 | 11/15/2011 | Common Stock | 89,200 | $15.6774 | D | |
Option (right to buy)(1) | 03/27/2004 | 03/26/2012 | Common Stock | 100,000 | $20.7979 | D | |
Option (right to buy)(1) | 02/17/2006 | 02/19/2013 | Common Stock | 100,000 | $15.6165 | D | |
Option (right to buy)(1) | 02/19/2007 | 02/18/2014 | Common Stock | 80,000 | $19.3208 | D |
Explanation of Responses: |
1. In a spin-off effective on June 30, 2004, Viad Corp ("Viad") distributed to its stockholders the shares of MoneyGram International, Inc. ("MGI"). At the time of the spin-off, holders of Viad stock received one share of MGI stock for each Viad share held on the record date of June 24, 2004. In addition, (a) all outstanding options to purchase Viad common stock were adjusted to consist of options to purchase Viad common stock and MGI common stock; (b) holders of stock units under deferred compensation plans of Viad received one MGI stock unit for each Viad stock unit held on the record date; and (c) holders of Viad restricted stock received one share of MGI restricted stock for each Viad share of restricted stock held on the record date. The securities ownership of the reporting person listed herein consists of the securities of MGI held immediately following the spin-off as a result of the spin-off distribution. |
Remarks: |
Claudia Saavedra for Robert H. Bohannon | 07/02/2004 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 5 (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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |