-----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, L9WU+A/z/6VKPqg0RzuT2OYC5nZRjSrGzeJ6sVGLilNAcvPDlv0qBSqJCX3d9mY/ 4MJblw5s7nnpxwRC+a0SrQ== 0001021408-02-007517.txt : 20020522 0001021408-02-007517.hdr.sgml : 20020522 20020522104508 ACCESSION NUMBER: 0001021408-02-007517 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020420 FILED AS OF DATE: 20020522 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 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: 02659430 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 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 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 box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Grossmann James T - -------------------------------------------------------------------------------- (Last) (First) (Middle) 805 South Fairfax - -------------------------------------------------------------------------------- (Street) Alexandria VA 22314 - -------------------------------------------------------------------------------- (City) (State) (Zip) CENTRAL EUROPEAN DISTRIBUTION CORP. (CEDC) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol CEDC - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an 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
- ---------------------------------------------------------------------------------------------------------------------------- 4. 5. 6. Securities Acquired (A) Amount of Ownership 3. or Disposed of (D) Securities Form: Transaction (Instr. 3, 4 and 5) Beneficially Direct 7. 2. Code --------------------- Owned at End (D) or Nature of 1. Transaction (Instr. 8) (A) of Month Indirect Indirect Title of Security Date ----------- Amount or Price (Instr. 3 and 4) (I) Beneficial (Instr. 3) (mm/dd/yy) Code V (D) (Instr. 4) Ownership (Instr. 4) - ---------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock 9/1/98 M 5,000 A 6.50 - ---------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock 5/6/02 S 600 D 16.40 - ---------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock 5/6/02 S 100 D 16.25 - ---------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock 5/7/02 S 400 D 16.25 - ---------------------------------------------------------------------------------------------------------------------------- CEDC Common Stock 5/13/02 S 3,900 D 16.25 1,000 D - ---------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------- - ---------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
5. Number of Derivative Securities Acquired (A) or Disposed 1. Title of Derivative 2. Conversion or Exercise 3. Transaction 4. Transaction of (D) Security (Instr. 3) Price of Derivative Security (Month/Day/Year) Code (Instr. 8) (Instr. 3, 4, and 5) - ------------------------------------------------------------------------------------------------------------------------------ Code V (A) (D) Director Stock option 6.50 5/13/02 M (D) 1,100 Director Stock option 6.50 5/16/02 M (D) 3,900
TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
Nature of 10. Ownership Indirect 7. Title and Form of 6. Date Exercisable Amount of 8. Price of 9. Number of Derivative Beneficial Underlying Derivative Derivative Securities Security: and Expiration Date Securities Security Beneficially Owned at Direct (D) or ownership (Instr. 3 and 4) (Instr. 5) End of Month (Instr. 4) Indirect (I) (Month/Day/Year) (Instr. 4) - ----------------------------------------------------------------------------------------------------------------------- (D) Date Expiration Title Amount Exercisable Date or Number of Shares 9/1/98 9/1/08 Common 1,100 (D) Stock 9/1/98 9/1/08 3,900 8,000 (D)
(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 5/22/02 - --------------------------------------- ----------------- **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. -----END PRIVACY-ENHANCED MESSAGE-----