4 1 rjm4.htm
 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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

   

Form 4

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OMB Number: 3235-0287

Expires: December 31, 2001

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hours per response 0.5

¨ Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).

   

(Print or Type Responses)

   

1 .Name and Address of Reporting Person

  1. Issuer Name and Ticker or Trading Symbol

Waste Connections Inc. / WCNX

6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

___X_Director ______10% Owner

___X_Officer (give ______Other (specify title below) below)

_Chairman, President and C.E.O.

Mittelstaedt, Ronald J.

(Last) (First) (Middle)

3. IRS Identification Number of Reporting Person, if an entity
(voluntary)

  1. Statement for
    Month/Year

February 2001

620 Coolidge Drive, Suite 350

(Street)

5. If Amendment,
Date of Original
(Month/Year)

7. Individual or Joint/Group Filing (Check Applicable Line)
_X_Form filed by One Reporting Person
___Form filed by More than One Reporting Person

Folsom, CA 95630

(City) (State) (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 4)

2. Trans-
action
Date


(Month/
Day/
Year)

3. Trans-
Action
Code
(Instr. 8)

 

 

4. Securities Acquired (A)
or Disposed of (D)
(Instr. 3, 4 AND 5)

5. Amount of
Securities
Beneficially
Owned at
End of Month

(Instr. 3 and 4)

6. Owner-
ship
Form:
Direct
(D) or
Indirect
(I)

(Instr. 4)

7. Nature of Indirect Beneficial Ownership



(Instr. 4)

Code

V

Amount

(A) or

(D)

Price

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 4(b)(v).

Persons who respond to the collection of information contained (Over)
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of
Derivative Security
(Instr. 4)

2. Conver-
sion or
Exercise
Price of
Deri-
vative
Security

3. Trans-
action
Date


(Month/
Day/
Year)

4. Trans-
action
Code
(Instr. 8)

 

 

 

 

 

 

5. Number of Deriv-
ative Securities Ac-
quired (A) or Dis-
posed of (D)
(Instr. 3, 4, and 5)

6. Date Exer-
cisable and
Expiration
Date
(Month/Day/
Year).

7. Title and Amount of Securities
Underlying
Derivative Security
(Inst. 4)

8. Price
of
Deriv-
ative
Secur-
ity
(Instr.
5)

9. Number
of deriv-
ative
Secur-
ities
Bene-
ficially
Owned
at End
of
Month
(Instr. 4)

10. Owner-
ship
Form of
Deriv-
ative
Security:
Direct
(D) or
Indirect
(I)
(Instr. 4)

11. Nature of Indirect
Beneficial Ownership
(Instr. 5)

 

Code

 

V

 

(A)

 

(D)

Date
Exer-
cisable

Expira-
tion
Date

Title

Amount or
Number of
Shares

Forward Purchase Agreement (obligation to sell)

(1)

2/28/01

J(1)

1

2/28/03

2/28/03

Common Stock

60,000

(1)

1

D

N/A

Forward Purchase Agreement (obligation to sell)

(2)

2/28/01

J(2)

1

2/28/04

2/28/04

Common Stock

60,000

(2)

1

D

N/A

Explanation of Responses:

(1) On February 28, 2001, the reporting person entered into a forward purchase agreement (the "Agreement") with a securities broker, under which the reporting person agreed to sell up to 60,000 shares of Common Stock to the broker on February 28, 2003. The reporting person was paid cash by the broker on February 28, 2001, in an amount equal to the present value of the minimum aggregate sale price for the shares (60,000 shares x $26.80 per share) on the maturity date, as specified in the Agreement. The number of shares sold at maturity depends on the stock price on that date. If the stock price on the maturity date is less than $26.80, the reporting person must transfer 60,000 shares to the broker. If the stock price at maturity is equal to or greater than $26.80 but less than $40.95, the reporting person must transfer a number of shares equal to 60,000 x ($26.80/stock price at maturity). If the stock price at maturity is $40.95 or greater, the reporting person must transfer a number of shares equal to 60,000 x (1 - ($40.95 - $26.80)/stock price at maturity).

(2) On February 28, 2001, the reporting person entered into a forward purchase agreement (the "Agreement") with a securities broker, under which the reporting person agreed to sell up to 60,000 shares of Common Stock to the broker on February 28, 2004. The reporting person was paid cash by the broker on February 28, 2001, in an amount equal to the present value of the minimum aggregate sale price for the shares (60,000 shares x $26.80 per share) on the maturity date, as specified in the Agreement. The number of shares sold at maturity depends on the stock price on that date. If the stock price on the maturity date is less than $26.80, the reporting person must transfer 60,000 shares to the broker. If the stock price at maturity is equal to or greater than $26.80 but less than $48.04, the reporting person must transfer a number of shares equal to 60,000 x ($26.80/stock price at maturity). If the stock price at maturity is $48.04 or greater, the reporting person must transfer a number of shares equal to 60,000 x (1 - ($48.04 - $26.80)/stock price at maturity).

 

 

/s/ Ronald J. Mittelstaedt March 9, 2001

**Signature of Reporting Person Date

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff

Note: File three copies of this Form, one of which must be manually signed. If space 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.