SEC Form 4
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
OMB APPROVAL
OMB Number: 3235-0287
Estimated average burden
hours per response: 0.5
  
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*
BERGMARK RICHARD L

(Last) (First) (Middle)
6316 WINDFERN

(Street)
HOUSTON TX 77040

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CORE LABORATORIES N V [ CLB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Executive VP and Treasurer
3. Date of Earliest Transaction (Month/Day/Year)
01/01/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 Shares 03/01/2004 P 263 A $20.83 38,566 I(1) Deferred Comp. Plan
Common Shares 03/02/2004 P 989 A $21.07 39,555(2) I(1) 401(k) Plan
Common Shares 125,597 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Option to Acquire Common Shares $6 09/21/1996 09/21/2005 Common Shares 20,000 20,000 D
Option to Acquire Common Shares $8.375 02/28/1998(3) 02/28/2007 Common Shares 96,000 116,000 D
Option to Acquire Common Shares $18.375 02/11/1999(3) 02/11/2008 Common Shares 20,000 136,000 D
Option to Acquire Common Shares $13.0625 04/07/2000(3) 04/07/2009 Common Shares 40,000 176,000 D
Option to Acquire Common Shares $19.375 02/23/2001(3) 02/23/2010 Common Shares 30,000 206,000 D
Option to Acquire Common Shares $16.1 04/03/2002(3) 04/03/2011 Common Shares 35,000 241,000 D
Option to Acquire Common Shares $10.26 09/26/2002(3) 09/26/2011 Common Shares 35,000 276,000 D
Option to Acquire Common Shares $10.26 09/26/2002(4) 09/26/2011 Common Shares 30,000 306,000 D
Option to Acquire Common Shares $8.84 03/13/2004(3) 03/13/2013 Common Shares 80,000 386,000 D
Performance Shares(5) $0(6) 12/31/2004 12/31/2004 Common Shares 20,000 406,000 D
Performance Shares(5) $0(6) 12/31/2005 12/31/2005 Common Shares 20,000 426,000 D
Performance Shares(5) $0(6) 01/01/2004 A 20,000 12/31/2006 12/31/2006 Common Shares 20,000 $0 446,000 D
Explanation of Responses:
1. These Common Shares were acquired pursuant to the Core Laboratories, Inc. Profit Sharing and Retirement Plan (the "401(k) Plan") or pursuant to the Core Laboratories, Inc. Deferred Compensation Plan (the "Deferred Comp Plan"), as the case may be, on various dates at various prices per share. The number of Common Shares shown in columns 4 and 5 of Table 1 is based on an allocation of the aggregate number of Common Shares acquired by the trustee under the 401(k) Plan or the Deferred Comp Plan, as the case may be, for the benefit of the plan participants who elected to make intra-plan transfers into the Common Share fund under the 401(k) Plan or the Deferred Comp Plan, as the case may be, at approximately the same time (pro rata, based on the dollar amount of each such participant's intra-plan transfer into the Common Share fund, rounding up or down to the nearest whole share).
2. The information reported herein is based on plan statements; the amount in Column 4 is for the particular plan transaction and the amount in Column 5 is for the combined plans.
3. This option is scheduled to become exercisable in 25% increments on each anniversary date.
4. This option is scheduled to become exercisable in 50% increments on each anniversary date.
5. Represents a grant of performance restricted shares which represent the right to receive our Common Shares in the future based on the performance of our Common Shares. None of these awards will vest unless our Common Shares perform better than the common stock of 50% of the companies comprising the Oil Service Sector Index (OSX) during the three-year period that began on the date of grant. If our Common Shares perform better than 75% of the companies comprising this index during such period, then all of the performance restricted shares will vest. If our common shares perform better than between 50% and 75% of the companies comprising the index, then an interpolated percentage of between 20% and 100% of the performance restricted shares will vest at the end of the three-year period. The executive will not receive dividends on or be entitled to vote the underlying Common Shares unless and until they have been issued at the end of the vesting period.
6. 1 for 1
/s/ John D. Denson, by power of attorney 03/03/2004
** 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 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.