-----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, Tsv/u0T2jNKBznSGSHnUkgV39pRDs2TwXMIKifE+ZPK3nh8ls81PMjUbQuvb/6rl 2o/UnFwJFuGiXhVT++9O5w== 0000950168-99-003141.txt : 19991214 0000950168-99-003141.hdr.sgml : 19991214 ACCESSION NUMBER: 0000950168-99-003141 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991213 FILED AS OF DATE: 19991213 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CUMULUS MEDIA INC CENTRAL INDEX KEY: 0001058623 STANDARD INDUSTRIAL CLASSIFICATION: RADIO BROADCASTING STATIONS [4832] IRS NUMBER: 364159663 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-24525 FILM NUMBER: 99773646 BUSINESS ADDRESS: STREET 1: 111 KILBOURNE AVE STREET 2: SUITE 2700 CITY: MILWAUKEE STATE: WI ZIP: 53202 BUSINESS PHONE: 4146152800 MAIL ADDRESS: STREET 1: 111 EAST KILBOURN AVE STREET 2: SUITE 2700 CITY: MILWAUKEE STATE: WI ZIP: 53202 COMPANY DATA: COMPANY CONFORMED NAME: SHERIDAN ROBERT H III CENTRAL INDEX KEY: 0001100892 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 100 N TRYON ST STREET 2: 25TH FL CITY: CHARLOTTE STATE: NC ZIP: 28255 MAIL ADDRESS: STREET 1: 100 N TRYON ST STREET 2: 25TH FL CITY: CHARLOTTE STATE: NC ZIP: 28255 4 1 FORM 4 FOR ROBERT H. SHERIDAN, III
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL [ ] CHECK THIS BOX IF NO LONGER WASHINGTON, D.C. 20549 OMB NUMBER 3235-0287 SUBJECT TO SECTION 16. FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP EXPIRES: SEPTEMBER 30, 1998 OR FORM 5 OBLIGATIONS MAY ESTIMATED AVERAGE BURDEN CONTINUE. SEE INSTRUCTION 1(B). HOURS PER RESPONSE.....0.5 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. Issuer Name and Ticker or 6. Relationship of Reporting Person(s) to Issuer Trading Symbol (Check all applicable) X Director 10% Owner ----- ----- Officer Other ----- ----- (give title below) (specify below) Sheridan, III, Robert H. Cumulus Media Inc. (CMLS) ---------------- - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. IRS 4. Statement or Social for Security Month/Year Number of Reporting Person (Voluntary) c/o BA Capital Company, L.P. f/k/a NationsBanc Capital Corporation 12/99 - ----------------------------------------------------------------------------------------------------------------------------- (Street) 5. If 7. Individual or Joint/Group Filing (Check Applicable Amendment, Line) Date of x Form filed by One Reporting Person 100 North Tryon Street, Floor 25 Original --- Charlotte, North Carolina 28255 (Month/Year) ___ Form filed by More than One Reporting Person - ------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I-- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------ 5. Amount of 6. Owner- Securities ship 2. Trans- 3. Trans- 4. Securities Acquired (A) Beneficially Form: action action or Disposed of (D) Owned at Direct 7. Nature of Date Code (Instr. 3, 4 and 5) End of (D) or Indirect 1. Title of (Month/ (Instr. 8) -------------------------------- Month Indirect Beneficial Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership (Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4) -------------------------- ---------------- ------ --- --------------- ---- --------- -------------- ------------- ---------- No securities owned -------------------------- ---------------- ------ --- --------------- ---- --------- -------------- ------------- ---------- ---------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------
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). (over) Sec 1474(7-96)
FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ----------------------------------------------------------------------------------------------------------------------------- 7. 5. 6. Title and Number of Date Exer- Amount of Derivative cisable and Underlying 2. 4. Securities Expiration Securities Conver- 3. Trans- Acquired (A) Date (Month/ (Instr. 3 sion or Trans- action or Disposed Day/Year) and 4) 1. Exercise action Code of (D) -------------- ---------------------- Title of Price of Date (Instr. (Instr. 3, Date Amount Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- Security ative Day/ -------- ---------- cis- ation ber of (Instr. 3) Security Year) Code V (A) (D) able Date Title Shares - ---------- -------- -------- ---- --- ---- ---- ------- ----- ----- ------ - ----------------------------------------------------------------------------------------------------------------------------- No securities owned - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - ----------------------------------------------------------------------------------------------------------------------------- - -------------------------------------------- 10. Ownership 9. Form of 8. Number of Deriv- Price derivative ative of Securities Security: Deriv- Benefi- Direct 11. ative cially (D) or Nature of Secur- Owned at Indirect Indirect ity End of (I) Beneficial (Instr. Month (Instr. Ownership 5) (Instr. 4) 4) (Instr. 4) ------ ---------- -------- ---------- - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ - ------------------------------------------ Explanation of Responses: ** Intentional misstatements or omissions of /s/ Robert H. Sheridan, III 12/9/99 facts constitute Federal Criminal Violations. -------------------------------- ------------ SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ** Signature of Reporting Person Date Robert H. Sheridan, III 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. Page 2 Sec 1474(7-96)
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