-----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, K1NCOe9VbjvNiDlLX75lA1YqPvU7GPjDVV3z0MoryLDYktuO14qLbfqknCt+ChDS HdWBemTLEOYMnTsKa3zRZA== 0001021408-01-511468.txt : 20020413 0001021408-01-511468.hdr.sgml : 20020413 ACCESSION NUMBER: 0001021408-01-511468 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011119 FILED AS OF DATE: 20011217 COMPANY DATA: COMPANY CONFORMED NAME: FINE N SCOTT CENTRAL INDEX KEY: 0001163556 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 600 3RD AVE CITY: NEW YORK STATE: NY ZIP: 10016 MAIL ADDRESS: STREET 1: 600 3RD AVE CITY: NEW YORK STATE: NY ZIP: 10016 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CENTRAL EUROPEAN DISTRIBUTION CORP CENTRAL INDEX KEY: 0001046880 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-BEER, WINE & DISTILLED ALCOHOLIC BEVERAGES [5180] IRS NUMBER: 541865271 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24341 FILM NUMBER: 1815742 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 3 1 d3.txt FORM 3 - SCOTT FINE /------------------------------/ / OMB APPROVAL / /------------------------------/ / OMB Number: 3235-0104 / / Expires: December 31, 2001 / / Estimated average burden / / hours per response...... 0.5 / /------------------------------/ +--------+ | FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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* Fine, N. Scott ---------------------------------------------------------------------------- (Last) (First) (Middle) c/o Fine Equities, Inc. 600 Third Avenue ---------------------------------------------------------------------------- (Street) New York NY 10016 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 11/19/01 -------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) 4. Issuer Name and Ticker or Trading Symbol Central European Distribution ----------------------------------- Corporation (CEDC) - ------------------- 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director ___ Officer ___ 10% Owner ___ Other --- (give title below) (specify below) ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) 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 Beneficially Owned
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
(Over) SEC 1473 (3-99) 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 5(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. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Scott N. Fine 12/17/01 - ------------------------------- ----------------- **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. Page 2 FORM 3 (continued) Table II--Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ Options(1) 3/5/00 3/4/09 Common Stock 46,100 $8.00 I See note (1) below - ------------------------------------------------------------------------------------------------------------------------------------ Warrants(2) 7/27/99 7/26/03 Common Stock 64,000 $8.45 I See note (2) below - ------------------------------------------------------------------------------------------------------------------------------------ Director Stock Options 11/19/01 11/18/11 Common Stock 1,500 $9.10 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Issued to, and held in the name of, Fine Equities, Inc. as compensation pursuant to a Consulting and Financial Agreement dated April 27, 1999. Mr Fine's wife is an owner of Fine Equities, Inc. (2) Issued to, and held in the name of, Fine Equities, Inc. as part of the underwriters' compensation paid in connection with CEDC's initial public offering July 1998. Mr Fine's wife is an owner of Fine Equities, Inc. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). /s/ Scott N. Fine 12/17/01 - ------------------------------- ----------------- **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. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----