-----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, SdGRSDkQjsWU4uv7Dw9bhFilROuLfFjefjJiHnf4X27JoN05SNawLsFteLcsqqwE 6XM4WSR0jfz4fyoV6Y34bw== /in/edgar/work/0000950168-00-002115/0000950168-00-002115.txt : 20000929 0000950168-00-002115.hdr.sgml : 20000929 ACCESSION NUMBER: 0000950168-00-002115 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000926 FILED AS OF DATE: 20000927 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CENTRAL EUROPEAN DISTRIBUTION CORP CENTRAL INDEX KEY: 0001046880 STANDARD INDUSTRIAL CLASSIFICATION: [5180 ] IRS NUMBER: 541865271 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-24341 FILM NUMBER: 729851 BUSINESS ADDRESS: STREET 1: PALM TOWER BUILDING STREET 2: 1343 MAIN STREET SUITE 301 CITY: SARASOTA STATE: FL ZIP: 34236 BUSINESS PHONE: 9413301558 MAIL ADDRESS: STREET 1: PALM TOWER BUILDING STREET 2: 1343 MAIN STREET SUITE 301 CITY: SARASOTA STATE: FL ZIP: 34236 COMPANY DATA: COMPANY CONFORMED NAME: EVANGALOU EVANGELOS CENTRAL INDEX KEY: 0001124882 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: US FOSA 37B M45 STREET 2: WARSAW POLAND 02-768 MAIL ADDRESS: STREET 1: US FOSA 37B M45 STREET 2: WARSAW POLAND 02-768 4 1 0001.txt FORM 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL [ ] CHECK THIS BOX IF NO LONGER WASHINGTON, D.C. 20549 OMB NUMBER 3235-0287 SUBJECT TO SECTION 16. FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP EXPIRES:DECEMBER 31, 2001 OR FORM 5 OBLIGATIONS MAY ESTIMATED AVERAGE BURDEN CONTINUE. SEE INSTRUCTION 1(B). HOURS PER RESPONSE.....0.5 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 (PRINT OR TYPE RESPONSES) - ---------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or 6. Relationship of Reporting Person(s) to Issuer Trading Symbol (Check all applicable) Director 10% Owner ----- ----- X Officer ----- Other (give title below) (specify below) Evangelou Evangelos Central European Distribution Corporation "CEDC" - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. IRS 4. Statement Identification for Number of Month/Year Reporting Person, if an entity (Voluntary) ul. FOSA 37B M.45 09/2000 - ----------------------------------------------------------------------------------------------------------------------------- (Street) 5. If 7. Individual or Joint/Group Filing (Check Applicable Amendment, Line) Date of _X_ Form filed by One Reporting Person Original ___ Form filed by More than One Reporting Person Warsaw Poland 02768 (Month/Year) - ------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I-- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. - --------------------- -------- ---------- ------------------------------ ----------- ---------- ---------- Amount of Owner- Securities ship Trans- Trans- Securities Acquired (A) Beneficially Form: action action or Disposed of (D) Owned at Direct Nature of Date Code (Instr. 3, 4 and 5) End of (D) or Indirect Title of (Month/ (Instr. 8) ---------------------------- Month Indirect Beneficial Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership (Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4) - --------------------- -------- ---- ---- ----------- ------ --------- ----------- ---------- ---------- Common Stock 28,200 D - ----------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) *If the form is filed by more than one reporting person, SEE Instruction 4(b)(v) POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER SEC 1472 (3-99)
FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. - ---------- -------- -------- -------- ---------- ------------ -------------- ------ ---------- --------- ---------- Title and Ownership Number of Date Exer- Amount of Form of Derivative cisable and Underlying Number of Deriv- Securities Expiration Securities Price Derivative ative Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security: sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership (Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4) - ---------- -------- -------- ---- --- ---- ---- ------- ----- ----- ------ ------ ---------- -------- ---------- Central European Distribution Corp. Common Stock $4.00 5/23/00 A 10,000 5/23/00 5/23/10 Common 10,000 39,000 Stock - ------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses:
** Intentional misstatements or omissions of /s/ Evangelos Evangelou 9/26/00 facts constitute Federal Criminal Violations. -------------------------------- ------------ SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a) ** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed. If space 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 the form displays a currently valid OMB Number. SEC 1472 (3-99) Page 2 -----END PRIVACY-ENHANCED MESSAGE-----