-----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, DH/qCt/WoEhRXsppGkSwaCsc1mKB+irCj/OL/vJsj3qQi/1Gwzcyhlyu8o2KXBR7 qFANWTFe6Hg844yy6oVXOg== 0001021408-02-006584.txt : 20020510 0001021408-02-006584.hdr.sgml : 20020510 ACCESSION NUMBER: 0001021408-02-006584 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020502 FILED AS OF DATE: 20020510 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/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-24341 FILM NUMBER: 02642252 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: CAREY WILLIAM V CENTRAL INDEX KEY: 0001084505 OWNER FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: PALM TOWER BUILDING STREET 2: 1343 MAIN STREET, #301 CITY: SARASOTA STATE: FL ZIP: 34236 BUSINESS PHONE: 9413301558 MAIL ADDRESS: STREET 1: PALM TOWER BUILDING STREET 2: 1343 MAIN STREET, #301 CITY: SARASOTA STATE: FL ZIP: 34236 4/A 1 d4a.txt FORM 4, AMENDMENT # 1 ------------------------------ 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 (Amendment No. 1) STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 [_] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 2(b). - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* CAREY WILLIAM V - -------------------------------------------------------------------------------- (Last) (First) (Middle) 1602 Cottagewood drive - -------------------------------------------------------------------------------- (Street) BRANDON FL 33511 - -------------------------------------------------------------------------------- (City) (State) (Zip) CENTRAL EUROPEAN DISTRIBUTION CORP. (CEDC) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol CEDC - -------------------------------------------------------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year 05/02 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) 5/9/02 ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [x] 10% Owner [X] Officer (give title below) [_] Other (specify below) Chief Executive 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) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
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)
- ----------------------------------------------------------------------------------------------------------------------------- 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) - ----------------------------------------------------------------------------------------------------------------------------- Director Stock Options $14.40 4/29/02 V (A) 6,000
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 Bene- Underlying Securities of of Deriv- ship ficial and (Instr. 3 and 4) Deriv- ative Form Expiration ative Secur- of De- Date Ownership Secur- ities rivative (Month/Day/ ity Bene- Security Year) (Instr. ficially Direct (D) (instr. 4) 5) Owned Indirect I - --------------------------------------------- at End (Instr. 4) Date Expira- Amount or of Exer- tion Title Number of Month cisable Date Shares (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ 4/29/02 4/29/12 Common 6,000 6,000 Stock
Explanation of Responses: ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ William Carey 5/10/02 - ----------------------------------------- ----------------- **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-----