-----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, Okw4vtfUl+j3mj8k/OX4QV5HyM/fDmAtYGWebJ4DRgyVpZ1QBVznrw50Kz3MfuPK keYwll6YxFbq94xDaVe1Dg== 0000914121-99-000427.txt : 19990507 0000914121-99-000427.hdr.sgml : 19990507 ACCESSION NUMBER: 0000914121-99-000427 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990430 FILED AS OF DATE: 19990506 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LODGIAN INC CENTRAL INDEX KEY: 0001066138 STANDARD INDUSTRIAL CLASSIFICATION: HOTELS & MOTELS [7011] IRS NUMBER: 522093696 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-14537 FILM NUMBER: 99612382 BUSINESS ADDRESS: STREET 1: 3445 PEACHTREE ROAD N E SUITE 700 CITY: ATLANTA STATE: CA ZIP: 30326 BUSINESS PHONE: 4043649400 MAIL ADDRESS: STREET 1: 3445 PEACHTREE ROAD N E SUITE 700 CITY: ATLANTA STATE: CA ZIP: 30326 COMPANY DATA: COMPANY CONFORMED NAME: COLE ROBERT S CENTRAL INDEX KEY: 0001075595 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER STATE OF INCORPORATION: GA FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: TWO LIVE OAK CENTER, SUITE 700 STREET 2: 3445 PEACHTREE RD. N.E. CITY: ATLANTA STATE: GA ZIP: 30326 BUSINESS PHONE: 4043649400 4 1 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP - ---------------------------- FORM 4 - ---------------------------- | |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) - ---------------------------- 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 - ------------------------------------- OMB Approval - ------------------------------------- OMB Number: 3235-0287 Expires: Estimated average burden hours per response...0.5 - -------------------------------------
- --------------------------------------------------- ------------------------------------------------------ ------------------------- 1. Name and Address of 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer Reporting Person* (Check all applicable) |X|Director | |10% Owner |X|Officer (give title below) | |Other (specify below) Cole Robert S. Lodgian, Inc. LOD Chief Executive Officer - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. I.R.S. or Social 4. Statement for 7. Individual or Joint/Group Filing Security Number of Month/Year (Check Applicable Line) Reporting Person (Voluntary) 4/99 |X|Form Filed by One Reporting Person | |Form Filed by More than One Reporting Person 3445 Peachtree Road, N.E., Suite 700 - ------------------------------------------- ------------------ (Street) 5. If Amendment, Date of Original (Month/Year) Atlanta GA 30326 - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------ ------------- ----------------- --------------------------------------------------------- 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial (Month/ Owned at End or Indirect Ownership Day/ of Month (I) (Instr. 4) Year) (Instr. 3 (Instr. 4) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Code V Amount (A) or (D) Price - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value 4/8/99 P 20,000 A 4.94 607,843 D $.01 per share - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value 4/12/99 J(1) 33,654 A 6.125 607,843 D $.01 per share - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 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).
FORM 4 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of of sion or action action Derivative Exer- and of of ship Indirect Deri- Exercise Date Code Securities cisable Amount Deri- Deri- Form Beneficial vative Price of (Instr. Acquired (A) and Expi- of vative vative of Deri- Ownership Secu- Deri- (Month/ 8) or Disposed ration Under- Secu- Secu- vative (Instr. 4) rity vative Day/ of (D) Date Lying rity rities Security: (Instr. Security Year) (Instr. 3, (Month/ Securi- (Instr. Benefi- Direct 3) 4, and 5) Day/ ties 5) cially (D) or Year) (Instr. Owned Indirect 3 and 4) at End (I) of (Instr. Month 4) (Instr. 4) -------------------------------------------------- Code V (A) (D) Date Expir- Title Amount Exerci- ation or sable Date Number of Shares -------------------------------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Shares represent the portion of shares issued, but held in escrow, pursuant to the merger of Impac Hotel Group, LLC and Servico, Inc. on December 11, 1998 (the "Merger"), and which were released from escrow after the completion of certain hotels. The certificates representing these shares are dated March 12, 1999, but were received by the Reporting Person on April 12, 1999 and are therefore reported currently. ** Intentional misstatements or omissions of /s/ Robert S. Cole May 6, 1999 facts constitute Federal Criminal -------------------------------------------- ------------------------------ Violations. ** Signature of Reporting Person Date See 18 U.S.C. 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 procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless form displays a currently valid OMB number.
-----END PRIVACY-ENHANCED MESSAGE-----