-----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, RPNAbvWaJGxYKpwFT+xhrK4rO8MGZ9LnKxVBYWlNpyLTGgy+JYeNIGV99cZlINfo BWsQFLaVDlpXl0Y8LpSrYg== 0000914121-99-000350.txt : 19990412 0000914121-99-000350.hdr.sgml : 19990412 ACCESSION NUMBER: 0000914121-99-000350 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990319 FILED AS OF DATE: 19990409 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LODGIAN INC CENTRAL INDEX KEY: 0001066138 STANDARD INDUSTRIAL CLASSIFICATION: HOTELS & MOTELS [7011] IRS NUMBER: 522093696 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-14537 FILM NUMBER: 99590513 BUSINESS ADDRESS: STREET 1: 3445 PEACHTREE ROAD N E SUITE 700 CITY: ATLANTA STATE: CA ZIP: 30326 BUSINESS PHONE: 4043649400 MAIL ADDRESS: STREET 1: 3445 PEACHTREE ROAD N E SUITE 700 CITY: ATLANTA STATE: CA ZIP: 30326 COMPANY DATA: COMPANY CONFORMED NAME: LEVEN MICHAEL A CENTRAL INDEX KEY: 0001040619 STANDARD INDUSTRIAL CLASSIFICATION: HOTELS & MOTELS [7011] DIRECTOR STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 13 CORPORATE SQUARE STREET 2: STE 250 CITY: ATLANTA STATE: GA ZIP: 30329 BUSINESS PHONE: 4043214045 MAIL ADDRESS: STREET 1: 13 CORPORATE SQUARE STREET 2: STE 250 CITY: ATLANTA STATE: GA ZIP: 30329 FORMER COMPANY: FORMER CONFORMED NAME: LAVEN MICHAEL A DATE OF NAME CHANGE: 19970609 4 1 FORM 4 FILING - ----------------------------- FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) - ----------------------------- 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - ------------------------------------- OMB Approval - ------------------------------------- OMB Number: 3235-0287 Expires: Estimated average burden hours per response...0.5 - -------------------------------------
- ---------------------------------------------------------------------------------------------------------- ------------------------- 1. Name and Address of 2. Issuer Name and Ticker 4. Statement for 6. Relationship of Reporting Person(s) to Issuer Reporting Person* or Trading Symbol Month/Year (Check all applicable) X Director [ ] 10% Owner Leven Michael A. Lodgian, Inc. 3/99 [ ] Officer (give title below) [ ] Other (specify - ----------------------------- below) (Last) (First) (Middle) LOD --------------------------------------------------- c/o Lodgian, Inc. 3445 Peachtree Road, N.E., Suite 700 ---------------------------------------------------------------------------------------------------- - ------------------------------ 3. I.R.S. Identification 5. If Amendment, 7. Individual or Joint/Group Filing (Street) Number of Reporting Date of (Check applicble Line) Person, if an entity Original [x] Form Field by One Reporting Person Atlanta GA 30326 (Voluntary) (Month/Year) [ ] Form Field by More than One Reporting Person - ------------------------------ (City) (State) (Zip) - ----------------------------------------------------------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------ ------------- ----------------- --------------------------------------------------------- 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial (Month/ Owned at End or Indirect Ownership Day/ of Month (I) (Instr. 4) Year) (Instr. 3 (Instr. 4) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Code V Amount (A) or (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ common Stock, par value 3/19/99 P 5,700 A $3.75 0 I By Spouse $.01 per share - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 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).
FORM 4 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of of sion or action action Derivative Exer- and of of ship Indirect Deri- Exercise Date Code Securities cisable Amount Deri- Deri- Form Beneficial vative Price of (Instr. Acquired (A) and Expi- of vative vative of Deri- Ownership Secu- Deri- (Month/ 8) or Disposed ration Under- Secu- Secu- vative (Instr. 4) rity vative Day/ of (D) Date Lying rity rities Security: (Instr. Security Year) (Instr. 3, (Month/ Securi- (Instr. Benefi- Direct 3) 4, and 5) Day/ ties 5) cially (D) or Year) (Instr. Owned Indirect 3 and 4) at End (I) of (Instr. Month 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Code V (A) (D) Date Expir- Title Amount Exerci- ation or sable Date Number of Shares - ------------------------------------------------------------------------------------------------------------------------------------ Option to $6.125 8/27/97 8/27/07 Common 5,000 I D Purchase Stock Common Shares - ------------------------------------------------------------------------------------------------------------------------------------ Option to $6.125 8/27/97 8/27/07 Common 20,000 I D Purchase Stock Common Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: ** Intentional misstatements or omissions of /s/ Michael A. Leven April 9, 1999 facts constitute Federal Criminal -------------------------------------------- ------------------------------ Violations. ** Signature of Reporting Person Date See 18 U.S.C. and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless form displays a currently valid OMB number.
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