-----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, Ek5klHIzKdj+xX5Pa+l8N+LfsZIAyyaI5cwLHKc58OSSHqr9chklbbAv66l6vLtZ H9TGUUmS3drScGCR68P9og== 0001017951-03-000040.txt : 20030310 0001017951-03-000040.hdr.sgml : 20030310 20030310082828 ACCESSION NUMBER: 0001017951-03-000040 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020828 FILED AS OF DATE: 20030310 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NIC INC CENTRAL INDEX KEY: 0001065332 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 522077581 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-26621 FILM NUMBER: 03597124 BUSINESS ADDRESS: STREET 1: 12 CORPORATE WOODS 10975 BENSON STREET STREET 2: SUITE 390 CITY: OVERLAND PARK STATE: KS ZIP: 66210 MAIL ADDRESS: STREET 1: 12 CORPORATE WOODS 10975 BENSON STREET STREET 2: SUITE 390 CITY: OVERLAND PARK STATE: KS ZIP: 66210 FORMER COMPANY: FORMER CONFORMED NAME: NATIONAL INFORMATION CONSORTIUM INC DATE OF NAME CHANGE: 19990504 FORMER COMPANY: FORMER CONFORMED NAME: NATIONAL INFORMATION CONSORTIUM DATE OF NAME CHANGE: 19990618 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: FRASER JEFFERY S CENTRAL INDEX KEY: 0001106139 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: P.O. BOX 4919 CITY: JACKSON STATE: WY ZIP: 83001 BUSINESS PHONE: 3077347140 4/A 1 form4a2_jsf082802.htm AMENDMENT NO. 2 TO FORM 4 DATED AUGUST 28, 2002 Form 4/A2 for Jeffery S. Fraser dated August 28, 2002

FORM 4/A

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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(h) of the Investment Company Act of 1940

  


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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*          




Fraser        Jeffery             S.   

2. Issuer Name and Ticker or Trading Symbol

 NIC Inc (EGOV)

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

 X 

Director

 X

10% Owner

 X 

Officer (give
title below)

 

Other (specify
below)

 President and Chief Executive Officer

(Last)                    (First)                (Middle)
c/o NIC Inc.
12 Corporate Woods
10975 Benson Street, Suite 390

3. I.R.S. Identification
   Number of Reporting
   Person, if an entity
   (Voluntary)

 

4. Statement for
    Month/Day/Year

 08-28-02



7. Individual or Joint/Group Filing (Check Applicable Line)

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

 08-28-02

 X 

Form filed by One Reporting Person

(Street)

 Overland Park    Kansas        66210    

   

Form filed by More than One Reporting Person

(City)                      (State)                  (Zip)

Table I  ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
    (Instr. 3)

2. Trans-
    action
    Date



  (Month/
    Day/
   Year)

2A.
Deemed
Execution
Date, if
any

  (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
    Following
    Reported
    Transaction(s)

    (Instr. 3 and 4)

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

  (Instr. 4)

7. Nature of
    Indirect
    Beneficial
    Owner-
    ship



   
(Instr. 4)

Code

V

Amount

(A)
or
(D)

Price

 Common Stock

 

 

 

 

 

 

 

21,074,192

I

(1)

 Common Stock

08-06-01

 

J(6)

 

   15,691

A

N/A

  6,100,117

I

(2)

 Common Stock

08/06/01

 

J(6)

 

        802

A

N/A

     312,068

I

(3)

 Common Stock

 

 

 

 

 

 

 

     150,000

I

(5)

 Common Stock

08/06/02

 

P

 

     2,000

A

$1.71

 

 

 

 Common Stock

08/07/02

 

P

 

  13,500

A

$1.69

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 See Attached Schedule

 

 

 

 

 

 

 

 

 

 

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
in this form are not required to respond unless the form displays
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(Over)
SEC 1474 (9-02)


Name of Reporting Person:     Jeffery S. Fraser

Issuer Name and Ticker or Trading Symbol:     NIC (EGOV)

Statement for Month/Year:     August 2002

FORM 4/A (continued)
Jeffery S. Fraser

Table I  ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
    (Instr. 3)

2. Trans-
    action
    Date



  (Month/
    Day/
   Year)

2A.
Deemed
Execution
Date, if
any

  (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
    Following
    Reported
    Transaction(s)

    (Instr. 3 and 4)

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

  (Instr. 4)

7. Nature of
    Indirect
    Beneficial
    Owner-
    ship



   
(Instr. 4)

Code

V

Amount

(A)
or
(D)

Price

 Common Stock

08/07/02

 

P

 

   50,000

A

$1.70

 

 

 

 Common Stock

08/09/02

 

P

 

    5,000

A

$1.70

 

 

 

 Common Stock

08/12/02

 

P

 

   10,000

A

$1.70

 

 

 

 Common Stock

08/13/02

 

P

 

   19,500

A

$1.6479

 

 

 

 Common Stock

08/28/02

 

P

 

   50,000

A

$1.72

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Page 2 of 3


FORM 4/A (continued)
Jeffery S. Fraser

Table II  ¾ Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative
    Security
    (Instr. 3)

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

3. Trans-
    action
    Date

(Month/
 Day/
Year)

3A.
Deemed
Execution
Date, if
any

  (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
    Underlying Securities
    (Instr. 3 and 4)

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

9. Number
   of deriv-
   ative
   Secur-
   ities
   Bene-
   ficially
   Owned
   Follow-
   ing
   Reported
   Trans-
   action(s)
   (Instr. 4)

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

11. Nature
     of
     Indirect
     Benefi-
     cial
     Owner-
     ship
     (Instr.
4)

Code

V

(A)

(D)

Date
Exer-
cisable

Expira-
tion
Date

Title

Amount or
Number of
Shares

(4)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

(1)  These shares are held directly by the National Information Consortium Voting Trust, which holds in the aggregate 27,469,884 shares, and indirectly by Mr. Fraser as
one of the trustees of the trust.  Mr. Fraser is the President, Chief Executive Officer, a director and a 10% owner of the issuer.
(2)  These shares are held directly by the National Information Consortium Voting Trust, for which Mr. Fraser acts as one of the trustees, for his benefit as a direct
beneficiary of the trust.
(3)  These shares are held directly by the National Information Consortium Voting Trust, for which Mr. Fraser acts as one of the trustees, for the direct benefit of the
Crimson Tide Charitable Remainder Unitrust, of which Mr. Fraser acts as trustee.
(4)  The Form 4 originally filed by Mr. Fraser incorrectly reported the grant of an option.
(5)  These shares are held directly by the Fraser Family Trust, and indirectly by Mr. Fraser as one of the trustees of the trust.
(6)  During 2001, the National Information Voting Trust repurchased units of the trust which beneficially owned 70,686 shares of the issuer.  The repurchased
units (and beneficial ownership of the underlying shares of the issuer) were distributed pro rata among the remaining beneficial owners of the trust.

 

 

/s/ Jeffery S. Fraser

          

 March 7, 2003

**

Intentional misstatements or omissions of facts constitute Federal Criminal Violations.

**Signature of Reporting Person

          

Date

See18 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 is insufficient,
         see Instruction 6 for procedure.

 

     

 

 

 

 

     

 

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required to respond unless the form displays a currently valid OMB Number.

 

     

 

 

 

     

 

 

 

     

Page 3

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