-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, PgURaARqnSN8qeeGVkYh7/MHJJN+ZFU5V0LV+ZNZ/AMh19iA1ClWnn3G+rQdsuIH QLxlw7t1lzJFO4EH88thNw== 0000950136-04-002427.txt : 20040804 0000950136-04-002427.hdr.sgml : 20040804 20040804123813 ACCESSION NUMBER: 0000950136-04-002427 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040804 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: NICKLIN WILLIAM FRED CENTRAL INDEX KEY: 0000925227 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 3 RIVERS EDGE CITY: NEWBURGH STATE: NY ZIP: 12550-1457 BUSINESS PHONE: 8008634783 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PEERLESS MANUFACTURING CO CENTRAL INDEX KEY: 0000076954 STANDARD INDUSTRIAL CLASSIFICATION: GENERAL INDUSTRIAL MACHINERY & EQUIPMENT, NEC [3569] IRS NUMBER: 750724417 STATE OF INCORPORATION: TX FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-14153 FILM NUMBER: 04950734 BUSINESS ADDRESS: STREET 1: 2819 WALNUT HILL LN CITY: DALLAS STATE: TX ZIP: 75229 BUSINESS PHONE: 2143576181 MAIL ADDRESS: STREET 1: P.O. BOX 540667 CITY: DALLAS STATE: TX ZIP: 75354 SC 13G/A 1 file001.txt AMENDMENT TO SCHEDULE 13G SCHEDULE 13G (RULE 13d-102) Information to be Included in Statements Filed Pursuant to Rule 13d-1(b), (c) and (d) and Amendments Thereto Filed Pursuant to Rule 13d-2. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 Under the Securities Exchange Act of 1934 (Amendment No. 4)* PEERLESS MANUFACTURING COMPANY - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 705514107 - -------------------------------------------------------------------------------- (CUSIP Number) November 5, 2003 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act, but shall be subject to all other provisions of the Act (however, see the Notes). - --------------------- ------------------- CUSIP NO. 705514107 13G PAGE 2 OF 4 PAGES - --------------------- ------------------- 1. Name of Reporting Persons/I.R.S Identification Nos. of Above Persons (Entities Only) William Fred Nicklin - ------------------------------------------------------------------------------ 2. Check the Appropriate Box if a Member of a Group (a) [ ] (See Instructions) (b) [X] - ------------------------------------------------------------------------------ 3. SEC Use Only - ------------------------------------------------------------------------------ 4. Citizenship or Place of Organization United States - ------------------------------------------------------------------------------ Number of 5. Sole Voting Power Shares 130,900 ------------------------------------------------------ Beneficially 6. Shared Voting Power None Owned by ------------------------------------------------------ 7. Sole Dispositive Power Each 130,900 ------------------------------------------------------ Reporting 8. Shared Dispositive Power None Person With - ------------------------------------------------------------------------------ 9. Aggregate Amount Beneficially Owned by Each Reporting Person 144,100 - ------------------------------------------------------------------------------ 10. Check Box if the Aggregate Amount in Row (9) Excludes Certain Shares See Instructions) [ ] No - ------------------------------------------------------------------------------ 11. Percent of Class Represented by Amount in Row (9) 4.80% - ------------------------------------------------------------------------------ 12. Type of Reporting Person (See Instructions) IN - ------------------------------------------------------------------------------- ITEM 1. (a) Peerless Manufacturing Company (b) 2819 Walnut Hill Lane Dallas, Texas 75229 ITEM 2. (a) William Fred Nicklin (b) 3 Rivers Edge Newburgh, NY 12550-1457 (c) United States. (d) Common Stock. (e) CUSIP No. 705514107 ITEM 3. Passive Investor ITEM 4. Ownership (a) Amount beneficially owned: 144,100 shares (b) Percent of class: 4.80% (c) Number of shares as to which the person has: (i) Sole power to vote of to direct the vote: 130,900 (ii) Shared po9wer to vote or direct the vote: none (iii) Sole power to dispose or to direct the disposition of: 130,900 (iv) Shared power to dispose or to direct the disposition of: none ITEM 5. Ownership of Five Percent or Less of a Class If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following: [X] ITEM 6. Ownership of More than Five Percent on Behalf of Another Person Not applicable. ITEM 7. Identification and Classification of the Subsidiary which Acquired The Security being Reported on by the Parent Holding Company Not applicable. ITEM 8. Identification and Classification of Members of the Group. Not applicable. ITEM 9. Notice of Dissolution of Group. Not applicable. ITEM 10. Certification By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participation in any transaction having that purpose or effect. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: December 4, 2003 /s/ William E. Nicklin ------------------------- William E. Nicklin -----END PRIVACY-ENHANCED MESSAGE-----