4 1 d4.txt FORM 4 - EVANGELOS EVANGELOU /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0287 / / Expires: September 30, 1998 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP of Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* EVANGELOU EVANGELOS -------------------------------------------------------------------------------- (Last) (First) (Middle) VI FOSA 37 M.4S -------------------------------------------------------------------------------- (Street) WARSAW POLAND 02 768 -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol CENTRAL EUROPEAN DISTRIBUTION CORP. ----------------------------------- (CEDC) ------ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) -------------- 4. Statement for Month/Year 06/01 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- =============================================================================== 6. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] Officer [_] 10% Owner [_] Other (give title below) (specify below) Chief Operating Officer ---------------------------------------------------------------- 7. 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 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ CEDC Common Stock (A) 40,200 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of 3 Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) ----------------------------------------------------------------------------------------------------------------------------- Central Euuropean $4.00 4/23/01 A 5,000 Distribution Corporation Common Stock
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of In- Date ative Secur- of De- direct (Month/Day/ Secur- ities rivative Bene- Year) ity Bene- Security ficial (Instr. 4) (Instr. ficially Owner- -------------------------------------------- 5) Owned ship Date Expira- Amount or at End (Instr. Exer- tion Title Number of of 4) cisable Date Shares Month (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ (D) Date Expiration Title Amount 45,200 (D) Exercisable Date of Number of shares 4/23/02 4/23/11 Common 5,000 Stock
(Print or Type Responses) Form 4-07/98 (Over) Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Critical Violations. /s/ EVANGELOS EVANGELOU 6/10/01 -------------------------------------------- ----------------- **Signature of Reporting Person Date Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. Page 2 of 3