3 1 form3_rlb1102.htm FORM 3 FOR RICHARD L. BROWN DATED NOVEMBER 2002 Form 3 for Richard L. Brown dated November 4, 2002


FORM 3

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

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(h) of the Investment Company Act of 1940

  


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(Print or Type Responses)

1. Name and Address of Reporting Person*

Brown           Richard           L.         

2. Date of Event
    Requiring Statement
    (Month/Day/Year)

 11-04-02

4. Issuer Name and Ticker or Trading Symbol



NIC Inc. (EGOV)

(Last)                               (First)                            (Middle)


 9715 State Road 39 North

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

 

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

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

 

   

Director

   

10% Owner

(Street)

 Rossville               IN                    46065

 X 

Officer (give title below)

   

Other (specify
  below)

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

 Executive Vice President – Technology
and Solutions

 X 

Form filed by One Reporting Person

(City)                               (State)                               (Zip)

   

Form filed by More than One Reporting Person

Table I ¾Non-Derivative Securities Beneficially Owned

1. Title of Security                                                                       
    (Instr. 4)

2. Amount of Securities
    Beneficially Owned
    (Instr. 4)

3. Ownership
    Form: Direct
    (D) or Indirect
    (I)   (Instr. 5)

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

 Common Stock

14,947

I

(1)

 Common Stock

      30

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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 5(b)(v).

 

                                                                    

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(Over)
SEC 1473 (7-02)


FORM 3 (continued)
(Richard L. Brown

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

1.Title of Derivative Security                                   
   (Instr. 4)

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

3. Title and Amount of Securities Underlying                                  
    Derivative Security
    (Instr. 4)

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

5. Owner-
    ship
    Form of
    Deriv-
    ative
    Security:
    Direct
    (D) or
    Indirect
    (I)
    (Instr. 5)

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

Date
Exer-
cisable

Expira-
tion
Date

                           Title                          

Amount
or
Number
of
Shares

Common Stock

01/04/99

01/04/03

 

39,274

$1.44

D

(2)

Common Stock

08/03/99

08/03/03

 

  2,700

$14.36  

D

 

Common Stock

01/04/00

01/04/04

 

  2,479

$32.875

D

(2)

Common Stock

01/04/00

01/04/04

 

    221

$32.875

D

 

Common Stock

05/22/00

05/22/10

 

  7,000

$10.375

D

(3)

Common Stock

12/18/00

12/18/05

 

10,000

 $2.219

D

(4)

Common Stock

06/25/01

06/25/06

 

  5,000

$2.10

D

(5)

Common Stock

07/23/02

07/23/05

 

15,000

$1.67

D

(6)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

 (1)  These shares are held directly by the National Information Consortium Voting Trust, for which Messrs. Jeffery S. Fraser and Ross C. Hartley act as trustees,
for the benefit of Mr. Brown as a direct beneficiary of the trust.
(3)  The option vests in three equal annual installments beginning on January 4, 2000.
(4)  The option vests in four equal annual installments beginning on May 22, 2000.
(5)  The option vests in four equal annual installments beginning on December 18, 2000.
(6)  The option vests in four equal annual installments beginning on June 25, 2001.
(7)  The option vests in four equal annual installments beginning on July 23, 2002.

 

 

 /s/ Richard L. Brown

          

03/23/03

**

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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