5 1 d85084de5.txt FORM 5 - MIKE WOODS 1 -------------------------- OMB APPROVAL -------------------------- ------ OMB Number: 3235-0362 FORM 5 Expires: December 31, 2001 ------ Estimated average burden hours per response.... 1.0 -------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] CHECK BOX IF NO LONGER SUBJECT TO SECTION 16. FORM 4 OR FORM 5 OBLIGATIONS MAY CONTINUE. SEE Filed pursuant to Section 16(a) of the Securities INSTRUCTION 1(b). Exchange Act of 1934, [ ] FORM 3 HOLDINGS Section 17(a) of the Public Utility REPORTED Holding Company Act of 1935 or Section 30(f) of [X] FORM 4 the Investment Company Act TRANSACTIONS of 1940 REPORTED ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Woods Mike Hastings Entertainment, Inc./HAST Issuer (Check all applicable) ------------------------------------------- --------------------------------------------- Director 10% Owner (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- --- Number of Reporting Month/Year X Officer (give Other (specify 3601 Plains Blvd Person (Voluntary) 1-31-2001 ---- title --- below) ------------------------------------------- ------------------- below) (Street) -------------------- 5. If Amendment, Chief Information Officer Date of Original Vice President - Information Systems Amarillo TX 79102 (Month/Year) ------------------------------------ ------------------------------------------- 7. Individual or Joint/Group Reporting (City) (State) (Zip) ------------------ (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 of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Month/ (Instr. end of Issuer's Direct Benefi- Day/ 8) Fiscal Year (D) or cial Year) ---------------------------- (Instr. 3 and 4) Indirect Owner- Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 10-10-2000 A 21,501 A (1) 23,851 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 141(2) I by 401k ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 986(3) I by ASOP ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ (1) Award of Restricted Stock Units was in exchange for outstanding options. See Table II. (2) Purchased shares through the company's 401k Plan. Information based on plan statement as of 1/31/01. (3) Purchased shares through the company's ASOP Plan. Information based on plan statement as of 1/31/01. *If the form is filed by more than one reporting person, see Instruction 4(b)(v). (Over) SEC 2270 (3-99) 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.
2
FORM 5 (CONTINUED) 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. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv- Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative Deriv- Day/ Disposed of (D) (Month/Day/ Secur- ative Year) (Instr. 3, 4, Year) ity Security and 5) (Instr. 5) ----------------------------------- Date Expira- Amount or --------------- Exer- tion Number of (A) (D) cisable Date Title Shares ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $10.28 10-10-00 H4 18,814 (5) 1/20/04 Stock 18,814 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $12.26 10-10-00 H4 22,766 (6) 8/26/05 Stock 22,766 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $14.03 10-10-00 H4 8,853 (7) 5/18/06 Stock 8,853 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $13.64 10-10-00 H4 15,177 (8) 8/28/07 Stock 15,177 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $11.88 10-10-00 H4 9,000 (9) 12/14/08 Stock 9,000 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $9.00 10-10-00 H4 9,000 (10) 3/30/09 Stock 9,000 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $12.00 10-10-00 H4 9,000 (11) 7/16/09 Stock 9,000 (4) ------------------------------------------------------------------------------------------------------------------------------------ Common Common Stock (Right to Buy) $9.69 10-10-00 H4 15,000 (12) 9/17/06 Stock 15,000 (4) ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of 10. Ownership 11. Nature of Derivative of Derivative Indirect Securities Security: Beneficial Beneficially Direct (D) Ownership Owned at End or Indirect (I) (Instr. 4) of Year (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------ Explanation of Responses: (4) Cancellation of Stock Options was in exchange for Restricted Stock Unit. See Table I. (5) Granted 1/20/94, vested 20% on each anniversary of 1/20/97. (6) Granted 8/26/95, vested 20% on each anniversary of 8/26/98. (7) Granted 5/18/96, vested 20% on each anniversary of 5/18/96. (8) Granted 8/28/97, vested 20% on each anniversary of 8/28/97. (9) Granted 12/14/98, vested 20% on each anniversary of 12/14/98. (10) Granted 3/30/99, vested 20% on each anniversary of 3/30/99. (11) Granted 7/16/99, vested 20% on each anniversary of 7/16/99. (12) Granted 9/17/99, vested 25% on each anniversary of 9/17/99. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ MIKE WOODS 3/15/01 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- ------- **Signature of Reporting Person Date Note. File three copies of this Form, one of which must be manually signed. Page 2 If space is insufficient, see Instruction 6 for procedure. SEC 2270 (3-99)
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.