4 1 d4.txt FORM 4 - JAN LASKOWSKI /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0287 / / Expires: December 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 (Print or Type Responses) -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* LASKOWSKI JAN W. -------------------------------------------------------------------------------- (Last) (First) (Middle) 10116 MARSZATKOWSKA M.6 -------------------------------------------------------------------------------- (Street) WARSAW POLAND 00-102 -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol CENTRAL EUROPEAN DISTRIBUTION CORP. ----------------------------------- (CEDC) ------ 3. I.R.S. 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) X Director ___ Officer ___ 10% Owner ___ Other --- (give title below) (specify below) ---------------------------------------------------------------- 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 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 European Distribution Corporation Common Stock $ 3.79 4/27/01 A 1,500 ----------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock $ 5.04 4/30/01 A 500 -----------------------------------------------------------------------------------------------------------------------------
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- Securities ficial (Instr. ficially Bene- Owner- -------------------------------------------- 5) Owned ficially ship Date Expira- Amount or at End Owned at (Instr. Exer- tion Title Number of of End of 4) cisable Date Shares Month Month(1) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ 4/27/02 4/27/11 Common Stock 1,500 $3.79 14,500 (D) ------------------------------------------------------------------------------------------------------------------------------------ 4/30/02 4/30/11 Common Stock 500 $5.04 15,000 D ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Jan Laskowski 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