4 1 brewer-form4.txt OLIVER G. BREWER III, FORM 4 DATED FEBRUARY 14, 2003 ----------------------------- OMB APPROVAL ----------------------------- OMB Number 3235-0287 Expires: December 31, 2005 Estimated average burden hours per response ..... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 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 [ ] CHECK THIS BOX IF NO LONGER SUBJECT OF SECTION 16. FORM 4 OR FORM 5 OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(B). ====================================================================== 1. Name and Address of Reporting Person Brewer Oliver (Chip) G., III ---------------------------------------------------------------------- (Last) (First) (Middle) 2801 East Plano Parkway ---------------------------------------------------------------------- (Street) Plano TX 75074 ---------------------------------------------------------------------- (City) (State) (Zip) ====================================================================== 2. Issuer Name and Ticker or Trading Symbol Adams Golf, Inc. (ADGO) ====================================================================== 3. IRS Identification Number of Reporting Person, if an entity (Voluntary) ====================================================================== 4. Statement for Month/Day/Year 02/14/2003 ====================================================================== 5. If Amendment, Date of Original (Month/Day/Year) ====================================================================== 6. Relationship of Reporting Person to Issuer (Check all applicable) [ X ] Director [ ] 10% Owner [ X ] Officer (give title below) [ ] Other (specify below) President and Chief Executive Officer ------------------------------------------ ====================================================================== 7. Individual or Joint/Group Filing (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 ============================================================================================================================= 6. 2A. 4. 5. Owner- 2. Deemed Securities Acquired (A) or Amount of ship Trans- Execution 3. Disposed of (D) Securities Form: 7. Nature action Date, if Transaction (Instr. 3, 4 and 5) Beneficially Direct of Indirect Date any Code --------------------------- Owned at End (D) or Beneficial 1. (Month/ (Month/ (Instr. 8) (A) of Month Indirect Ownership Title of Security Day/ Day/ ------------ Amount or Price (Instr. 3 (I) (Instr. (Instr. 3) Year Year) Code V (D) and 4) (Instr.4) 4) ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ============================================================================================================================= Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ==================================================================================================================================== 9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 3A. 4. Securities Date Securities Price Bene- ity: In- cise 3. Deemed Trans- Acquired (A) Exercisable and Instr. 3 and 4) of ficially Direct direct Price Trans- Execution action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date, if Code of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date any (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ Day/ ------- ---------------- Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Year Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options (right to 02/14/ 07/31/ 02/14 Common purchase) $0.01 2003 A 389,897 2003 2013 Stock 389,897 389,897 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ O.G. BREWER III 02/17/2003 ----------------------------------------- ------------- **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(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedures.