-----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, M6nMlkWflCXzcIs9rxKAtctP2x6lFnGJUuiOWHnC4nfvyS9s6Tf25bSCaZIvgIeU Wd18XZLtZgYXYTGtjv5y4Q== 0001021408-02-006465.txt : 20020509 0001021408-02-006465.hdr.sgml : 20020509 ACCESSION NUMBER: 0001021408-02-006465 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020420 FILED AS OF DATE: 20020509 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: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24341 FILM NUMBER: 02640287 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: GROSSMAN JAMES T CENTRAL INDEX KEY: 0001124877 DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 805 S. FAIRFAX ST CITY: ALEXANDRIA STATE: VA ZIP: 22314 MAIL ADDRESS: STREET 1: 805 S. FAIRFAX ST CITY: ALEXANDRIA STATE: VA ZIP: 22314 4 1 d4.txt FORM 4 ------------------------------- OMB APPROVAL ------------------------------- OMB NUMBER 3235-0287 Expires: September 30, 1998 Estimated average burden hours per response..........0.5 ------------------------------- U.S SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGE IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a0 of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b) ________________________________________________________________________________ 1. Name and Address of Reporting Parent. Grossmann James T. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 805 South Fairfax Street - -------------------------------------------------------------------------------- (Street) Alexandria VA 22314 - -------------------------------------------------------------------------------- (City) (State) (Zip) CENTRAL EUROPEIAN DISTRIBUTION CORP. (CEDC) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticket or Trading Symbol CEDC - -------------------------------------------------------------------------------- 3. IRS Identification Number of reporting person, If and Entity (Voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year 5/02 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting person to Issuer (check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [ ] Other (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
- ------------------------------------------------------------------------------------------------------------------------------------ 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) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly Page 1 of 2 TABLE II- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
Derivative Acquired 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Securities Security (Instr. 3) sion of action tion Code (A) or Disposed Exercise Date (Instr. 8) of (D) Price of (Month/ (Instr. 3, 4 and 5) Deriv- Day/ ative Year) Security - ----------------------------------------------------------------------------------------------------------------------------- Code V (A) (D) Director Stock Options $14.40 4/29/02 V(A) 1,500
TABLE II-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
Nature of Indirect 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- cisable Underlying Securities of of Deriv- ship Beneficial (Instr. 3 and 4) Deriv- ative Form and ative Secur- of De- Expiration Secur- ities rivative Date Ownership ity Bene- Security: (Month/Day/ (Instr. ficially Direct (D) Year) (Instr. 4) 5) Owned or Indirect at End (I) (Instr. 4) of Month (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Date Expira- Amount or Exer- tion Title Number of cisable Date Shares 4/29/02 4/29/12 Common 1,500 1,500 (D) Stock
(Print or Type Responses) (Form 4-07-98) (Over) Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ James Grossmann 5/9/02 - --------------------------------------- ----------------- **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 2 -----END PRIVACY-ENHANCED MESSAGE-----