-----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, FZb75speHSvJ/MeZvZLxd03TVLRY6lVrlne4oeQAAq8X1CNuqle4HA6b5D9QhQT/ KLfZxXq7dT1hzBrI76YPAw== 0001022640-96-000002.txt : 19960924 0001022640-96-000002.hdr.sgml : 19960924 ACCESSION NUMBER: 0001022640-96-000002 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960923 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BASSETT FURNITURE INDUSTRIES INC CENTRAL INDEX KEY: 0000010329 STANDARD INDUSTRIAL CLASSIFICATION: WOOD HOUSEHOLD FURNITURE, (NO UPHOLSTERED) [2511] IRS NUMBER: 540135270 STATE OF INCORPORATION: VA FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-00209 FILM NUMBER: 96633286 BUSINESS ADDRESS: STREET 1: MAIN ST STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 BUSINESS PHONE: 7036296000 MAIL ADDRESS: STREET 1: MAIN ST STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 COMPANY DATA: COMPANY CONFORMED NAME: MILLER DOUGLAS W CENTRAL INDEX KEY: 0001022640 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O BASSETT FURNITURE INDUSTRIES INC STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 BUSINESS PHONE: 5406296000 MAIL ADDRESS: STREET 1: C/O BASSET FURNITURE INDUSTRIES INC STREET 2: P O BOX 626 CITY: BASSETT STATE: VA ZIP: 24055 3 1 FORM 3 - SEPTEMBER 1996 U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person MILLER, DOUGLAS W BASSETT FURNITURE INDUSTRIES, INC. 245 MAIN STREET P O BOX 626 BASSETT, VA 24055 USA 2. Date of Event Requiring Statement (Month/Day/Year) september 1996 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### 4. Issuer Name and Ticker or Trading Symbol BASSETT FURNITURE INDUSTRIES, INC. BSET 5. Relationship of Reporting Person to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) VICE PRESIDENT-ADMINISTRATION 6. If Amendment, Date of Original (Month/Day/Year)
___________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. Amount of |3. Ownership |4. Nature of Indirect | | Securities | Form: | Beneficial Ownership | | Beneficially | Direct(D) or | | | Owned | Indirect(I) | | ___________________________________________________________________________________________________________________________________| NO STOCK OWNED AT PRESENT TIME |0 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Date Exer- |3.Title and Amount | |4. Conver-|5. Owner- |6. Nature of Indirect | Security | cisable and | of Underlying | |sion or |ship: | Beneficial Ownership | | Expiration | Securities | |exercise |Form of | | | Date(Month/ |-----------------------|---------|price of |Deriv- | | | Day/Year) | |Amount |deri- |ative | | | Date | Expira- | |or |vative |Security: | | | Exer- | tion | Title |Number of|Security |Direct(D) or | | | cisable | Date | |Shares | |Indirect(I) | | ___________________________________________________________________________________________________________________________________| **OPTION (RIGHT TO BUY) |1-01-97 |5-04-2004|COMMON STOCK |1000 |26.25 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: **GRANTED UNDER THE 1993 LONG TERM INCENTIVE PLAN, WHICH IS A RULE 16b-3 PLAN. SIGNATURE OF REPORTING PERSON DOUGLAS W. MILLER DATE 9-11-96 -----END PRIVACY-ENHANCED MESSAGE-----