-----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, Vg0HMs1x0cjvaSrIlVngIz4N+BDcbGwxn0wCsxT3AxHZobmXPp86I65vHLvk+OKR 5WgwNPyJ/twAUQSDJtTucw== 0000889812-00-000728.txt : 20000215 0000889812-00-000728.hdr.sgml : 20000215 ACCESSION NUMBER: 0000889812-00-000728 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000101 FILED AS OF DATE: 20000214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PANTRY INC CENTRAL INDEX KEY: 0000915862 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CONVENIENCE STORES [5412] IRS NUMBER: 561574463 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 3/A SEC ACT: SEC FILE NUMBER: 000-25813 FILM NUMBER: 537350 BUSINESS ADDRESS: STREET 1: 1801 DOUGLAS DR STREET 2: PO BOX 1410 CITY: SANFORD STATE: NC ZIP: 27330 BUSINESS PHONE: 9197746700 MAIL ADDRESS: STREET 1: 1801 DOUGLAS DR STREET 2: PO BOX 1410 CITY: SANFORD STATE: NC ZIP: 27330 COMPANY DATA: COMPANY CONFORMED NAME: CB CAPITAL INVESTORS LP CENTRAL INDEX KEY: 0001056596 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER IRS NUMBER: 133986302 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: 380 MADISON AVENUE 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 2126223100 MAIL ADDRESS: STREET 1: 380 MADISON AVENUE 12TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10017 3/A 1 FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 3 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 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* CB Capital Investors, LLC ("CBCI, LLC") (FN 1) - -------------------------------------------------------------------------------- (Last) (First) (Middle) 380 Madison Avenue, 12th Floor - -------------------------------------------------------------------------------- (Street) New York, NY 10017 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Date of Event Requiring Statement (Month/Day/Year) 1/1/2000 - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an entity (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol The Pantry, Inc. ("PTRY") - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) |_| Director |X| 10% Owner |_| Officer (give title below) |_| Other (specify below) ________________________________________ - -------------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) 06/08/99 - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check applicable line) |_| Form filed by One Reporting Person |X| Form filed by More than One Reporting Person ================================================================================ - -------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Beneficially Owned - --------------------------------------------------------------------------------
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 956,322 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
* If the Form is filed by more than one Reporting Person see instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Page 1 of 2 FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Pursuant to an internal reorganization effective as of January 1, 2000, (i) CB Capital Investors, LLC ("CBCI, LLC") became the successor to CB Capital Investors, LP ("CBCI, LP"), (ii) CB Capital Investors, Inc. ("CBCI, Inc.") became the managing member of CBCI, LLC, and Chase Capital Partners ("CCP") became the manager, by delegation, of CBCI, LLC pursuant to a master advisory agreement with CBCI, Inc. The internal reorganization changed CBCI, LP's name and form of organization but did not alter the proportionate interests of its ultimate security holders. CB Capital Investors, LLC ** Signature of Reporting Person By: Chase Capital Partners, as Manager By: ____________________________ Title: _________________ of Chase Capital Partners 2/ /2000 ------------ Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). 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 7
- ------------------------------------------------------------------------------------------------------------------------------------ Title of Derivative Date of Title and Securities and Ownership Nature of Disclaims Name and Address Designated Event Issuer Name, Amount of Title and Form: Indirect Pecuniary of Reporting Reporter(1) Requiring Ticker Security Amount of Direct (D) or Beneficial Interest Person Statement or Trading Symbol Securities Indirect (I) Ownership Underlying Derivative Securities - ------------------------------------------------------------------------------------------------------------------------------------ John R. Baron CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Mitchell J. Blutt CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Chris C. Behrens CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Arnold L. Chavkin CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Eric Green CB Capital January 1, The Pantry, Inc. Common N/A I See Yes c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 100 - ------------------------------------------------------------------------------------------------------------------------------------ Michael R. Hannon CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Donald J. Hofmann CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Page 3 of 7 - ------------------------------------------------------------------------------------------------------------------------------------ Stephen P. Murray CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below Capital Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ John M.B. CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No O'Connor Investors, LLC 2000 ("PTRY") Stock Note 2 below C/o Chase 956,322 Capital Partners 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Susan L. Segal CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory Yes c/o Chase Capital Investors, LLC 2000 ("PTRY") Stock Note 2 below Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Shahan D. CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No Soghikian Investors, LLC 2000 ("PTRY") Stock Note 2 below c/o Chase 956,322 Capital Partners 50 California Street, Suite 2940 San Francisco, CA 94111 - ------------------------------------------------------------------------------------------------------------------------------------ Jeffrey C. Walker CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below Capital Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Timothy J. Walsh CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below Capital Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Richard D. Waters CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory Yes c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below Capital Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Damion E. Wicker CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below Capital Partners 956,322 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Page 4 of 7 - ------------------------------------------------------------------------------------------------------------------------------------ CCP European CB Capital January 1, The Pantry, Inc. Common N/A I See No Principals, LLC Investors, LLC 2000 ("PTRY") Stock Explanatory c/o Chase 956,322 Note 2 below Capital Partners 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ CCP Principals, CB Capital January 1, The Pantry, Inc. Common N/A I See No LLC c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 2 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Chase Capital CB Capital January 1, The Pantry, Inc. Common N/A I See No Corporation Investors, LLC 2000 ("PTRY") Stock Explanatory (f/k/a Chemical 956,322 Note 2 below Capital Corporation) c/o Chase Capital Partners 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ The Chase CB Capital January 1, The Pantry, Inc. Common N/A I See No Manhattan Investors, LLC 2000 ("PTRY") Stock Explanatory Corporation 956,322 Note 3 below 270 Park Avenue 35th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Chase Capital CB Capital January 1, The Pantry, Inc. Common N/A I See No Partners Investors, LLC 2000 ("PTRY") Stock Explanatory 380 Madison 956,322 Note 4 below Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ The Chase CB Capital January 1, The Pantry, Inc. Common N/A I See No Manhattan Bank Investors, LLC 2000 ("PTRY") Stock Explanatory 270 Park Avenue 956,322 Note 5 below 35th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ David Ferguson CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 6 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ I. Robert Greene CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No c/o Flatiron Investors, LLC 2000 ("PTRY") Stock Note 7 below Partners 956,322 257 Park Avenue South 12th Floor New York, NY 10010 - ------------------------------------------------------------------------------------------------------------------------------------ Page 5 of 7 - ------------------------------------------------------------------------------------------------------------------------------------ Brian J. Richmand CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 8 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------ Jonas Steinmann CB Capital January 1, The Pantry, Inc. Common N/A I See No c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory Capital Partners 956,322 Note 9 below 380 Madison Avenue 12th Floor New York, NY 10017 - ------------------------------------------------------------------------------------------------------------------------------------
Explanatory Note: 1) The Designated Reporter is executing this report on behalf of all reporting persons, each of whom has authorized it to do so. 2) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because the reporting person is a partner of Chase Capital Partners ("CCP"), which is the manager, by delegation, of CBCI, LLC, pursuant to an advisory agreement with CB Capital Investors, Inc. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting of interests within CCP and CBCI, LLC. 3) The amount shown in Table I represents beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because it is (i) the sole stockholder of Chase Capital Corporation, which is a general partner of CCP, the non-managing member of CBCI, LLC and manager, by delegation of CBCI, LLC, pursuant to an advisory agreement with its managing member, and (ii) the sole stockholder of The Chase Manhattan Bank, the sole stockholder of CB Capital Investors, Inc. (the managing member of CBCI, LLC). The actual pro rata portion of such beneficial ownership that may be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting of interests within CCP and CBCI, LLC. 4) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because it is the non-managing member of CBCI, LLC and the manager, by delegation of CBCI, LLC, pursuant to an advisory agreement with the managing member of CBCI, LLC. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting of interests within CCP and CBCI, LLC. 5) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because it is the sole stockholder of the managing member of CBCI, LLC. 6) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because he was a general partner of CCP, the non-managing member of CBCI, LLC and the manager, by delegation of CBCI, LLC, until June 1, 1997. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting within CCP and CBCI, LLC. 7) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because he was a general partner of CCP, the non-managing member of CBCI, LLC and the manager, by delegation of CBCI, LLC, until May 31, 1999. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting within CCP and CBCI, LLC. Page 6 of 7 8) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because he was a general partner of CCP, the non-managing member of CBCI, LLC and the manager, by delegation of CBCI, LLC, until December 31, 1999. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting within CCP and CBCI, LLC. 9) The amount shown in Table I represents the beneficial ownership of the Issuer's equity securities by CBCI, LLC, a portion of which may be deemed attributable to the reporting person because he was a general partner of CCP, the non-managing member of CBCI, LLC and the manager, by delegation of CBCI, LLC, until July 1, 1999. The actual pro rata portion of such beneficial ownership that may be deemed to be attributable to the reporting person is not readily determinable because it is subject to several variables, including the internal rate of return and vesting within CCP and CBCI, LLC. Page 7 of 7 -----END PRIVACY-ENHANCED MESSAGE-----