-----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, K2UY8svFhb4Wxf7lY55zxn9KR7tKzfBg6ea0vzEg+Joqv39WJjbvzhmOvUSf89m6 DlnLhwzSDPEXvfKc12qD7g== 0001021408-02-010139.txt : 20020802 0001021408-02-010139.hdr.sgml : 20020802 20020802170339 ACCESSION NUMBER: 0001021408-02-010139 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020702 FILED AS OF DATE: 20020802 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: 02718632 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: ROBERTS RICHARD S CENTRAL INDEX KEY: 0001179125 DIRECTOR FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 21361 CLAPPERTOWN DR CITY: ASHBURN STATE: VA ZIP: 20147 3 1 d3.txt FORM 3 ---------------------------- 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* 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol Requiring Statement Roberts Richard S. (Month/Day/Year) Central European Distribution Corporation (CEDC) 7/2/02 - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. I.R.S. Identification 5. Relationship of Reporting Person(s) to Issuer Number of Reporting (Check all applicable) 21361 Clappertown Dr. Person, if an entity - ---------------------------------------------- (voluntary) X Director _______ 10% Owner (Street) --- . Officer (give ______ Other (specify Ashburn VA 20147 --- title below) below) - ---------------------------------------------- (City) (State) (Zip) 6. If Amendment, Date of 7. Individual or Joint/Group - ---------------------------------------------- Original (Month/Day/Year) 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 of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial Ownership (Instr. 4) Beneficially Owned Form: Direct (Instr. 5) (Instr. 4) (D) or Indirect (I) (Instr.5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ No Securities Owned - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
(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 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 Indirect Security cisable and Underlying Derivative Security or Form of Beneficial (Instr. 4) Expiration (Instr. 4) Exercise Derivative Ownership Date Price of Security: (Instr. 5) (Month/Day/ Derivative Direct (D) Year) Security or ----------------------- --------------------------- Indirect Date Expira- Amount (I) Exer- tion Title or (Instr. 5) cisable Date Number of Shares - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Richard S. Roberts 8/2/02 ----------------------------------------------- **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. 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-----