FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
DIEBOLD INC [ DBD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/07/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 11/07/2003 | M(1) | 2,625 | A | $28.59 | 8,668 | D | |||
Common Stock | 11/07/2003 | M(2) | 2,000 | A | $29.91 | 10,668 | D | |||
Common Stock | 11/07/2003 | F(3) | 3,338 | D | $56.55 | 7,330 | D | |||
Common Stock | 2,000 | I | By Spouse(4) | |||||||
Common Stock | 1,000 | I | By Spouse's IRA(4) | |||||||
Common Stock | 33,097 | I | By self as Advisor to Trustee(5) | |||||||
Common Stock | 11/07/2003 | S | 4,000 | D | $56.5 | 80,000 | I | By self as Co-Trustee(6) | ||
Common Stock | 1,000 | I | By self as Co-Trustee(4)(7) | |||||||
Common Stock | 1,000 | I | By self as Co-Trustee(4)(8) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Options to buy | $28.59 | 11/07/2003 | M | 2,625 | (9) | 04/18/2005 | Common Stock | 2,625 | $0 | 875 | D | ||||
Options to buy | $29.91 | 11/07/2003 | M | 2,000 | (10) | 04/25/2006 | Common Stock | 2,000 | $0 | 2,000 | D |
Explanation of Responses: |
1. Reflects the acquisition of a total of 2,625 shares of the issurer's common stock pursuant to an exercise of options under a Non-qualified Stock Option plan under Diebold, Inc. 1991 Equity and Performance Incentive Plan. |
2. Reflects the acquisition of a total of 2,000 shares of the issurer's common stock pursuant to an exercise of options under a Non-qualified Stock Option plan under Diebold, Inc. 1991 Equity and Performance Incentive Plan. |
3. Reflects the surrender of 2,385 shares of the issuer's common stock in payment of option price upon exercise of the stock options set forth in footnotes (1) and (2) above, and the withholding of 953 shares of issuer's common stock in payment of tax withholding obligations upon the exercise of these options. The transactions described in footnotes (1) and (2) above and these transactions in footnote (3) resulted in a net increase of 1,287 shares of issuer's common stock beneficially owned by the Reporting Person. |
4. The undersigned disclaims any beneficial ownership. |
5. By self as Advisor to Trustee for W.R. Timken, Jr. Revocable Trust |
6. By self as Co-Trustee for Trust Under Will of H.H. Timken, Jr. |
7. By self as Co-Trustee for W.R. Timken Trust FBO Kristin T. Kingery's Children |
8. By self as Co-Trustee of W.R. Timken Trust FBO Great-Grandchildren |
9. Non-qualfied Stock Options granted under the Diebold, Inc. 1991 Equity and Performance Incentive Plan, as amended and restated. Options become exercisable in annual 25 percent increments beginning April 19, 2001, the first anniversary of the date of the grant. |
10. Non-qualfied Stock Options granted under the Diebold, Inc. 1991 Equity and Performance Incentive Plan, as amended and restated. Options become exercisable in annual 25 percent increments beginning April 26, 2002, the first anniversary of the date of the grant. |
Remarks: |
W.R. Timken, Jr. | 11/12/2003 | |
** 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 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). | ||
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. |