-----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, TnReWFlRq2tXsr9EQ/4XrCFY7WAEgzefFmQQ6qECX0C1FYuwTtUoG5aXCCYk0TP5 RD9Fju4IAsGQg//SESk8+w== 0000950142-99-000933.txt : 19991230 0000950142-99-000933.hdr.sgml : 19991230 ACCESSION NUMBER: 0000950142-99-000933 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991220 FILED AS OF DATE: 19991229 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: 3 SEC ACT: SEC FILE NUMBER: 001-14537 FILM NUMBER: 99782674 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: YUNG WILLIAM J CENTRAL INDEX KEY: 0001097189 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 207 GRANDVIEW DRIVE CITY: FT MITCHELL STATE: KY ZIP: 41017 BUSINESS PHONE: 6063310091 MAIL ADDRESS: STREET 1: 207 GRANDVIEW DRIVE CITY: FT MITCHELL STATE: KY ZIP: 41017 3 1 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP
U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 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(f) of the Investment Company Act of 1940 -------------------------------- OMB APPROVAL - ----------------------------------- -------------------------------- FORM 3 OMB Number: 3235-0104 - ----------------------------------- Expires: December 31, 2001 Estimated average burden hours per response .... 0.5 --------------------------------
1. Name and Address of Reporting Person * Casuarina Cayman Holdings Ltd. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 207 Grandview Drive - -------------------------------------------------------------------------------- (Street) Fort Mitchell KY 41017 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement ( Month / Day / Year ) 12/20/99 - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol Lodgian, Inc./LOD - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) Director X 10% Owner ----- ----- Officer (give title Other ----- below) ----- (specify below) - -------------------------------------------------------------------------------- 6. If Amendment, Date or Original (Month/Year) - -------------------------------------------------------------------------------- 7. Individual or Join/Group Filing (Check Applicable Line) Form filed by One Reporting Person ----- X Form filed by More than One Reporting Person ----- - --------------------------------------------------------------------------------
TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED 1. Title of security 2. Amount of Securities 3. Ownership 4. Nature of Indirect (Inst.4) Beneficially Owned Form: Direct (D) Beneficial Ownership (Instr. 4) or Indirect (I) (Instr. 5) (Inst. 5) - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- Common Stock, par value $0.01 per share 2,941,700 (1) (1) - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- - ---------------------------------------------- ------------------------------ ------------------- ------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the Form is filed by more than one reporting person, SEE instruction 5(b)(v). SEC 1473(8-92)
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FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 1. Title of Derivative Security 2. Date Exercisable and 3. Title and Amount of Securities Underlying (Instr. 4) Expiration Date Derivative Security (Instr. 4) (Month/Day/Year) Amount or Date Expiration Title Number of Exercisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ None. - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 4. Conversion or 5. Ownership 6. Nature of Indirect Exercise Price of Form of Beneficial Ownership Derivative Derivative (Instr. 5) Security Security: Direct (D) or Indirect (I) (Instr. 5) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
Explanation of Responses: (1) Casuarina Cayman Holdings Ltd. ("Casuarina") directly owns 343,600 shares of Lodgian, Inc. Common Stock, par value $0.01 per share (the "Shares"). Because William J. Yung may be deemed to control Casuarina, William J. Yung and Casuarina may be deemed to have beneficial ownership and voting and dispositive control of all such Shares held directly by Casuarina. In addition, the 1994 William J. Yung Family Trust (the "1994 Trust"), The 1998 William J. Yung and Martha A. Yung Family Trust (the "1998 Trust"), Edgecliff Management, LLC ("Management"), Edgecliff Holdings LLC ("Holdings"), Joseph Yung and William J. Yung, may pursuant to Rule 13d-5 of the Securities Exchange Act of 1934 (the "Securities Act"), be deemed to be the beneficial owner of the 343,600 Shares owned directly by Casuarina. Holdings directly owns 2,598,100 Shares. William J. Yung as the sole managing member of Management, which is the sole managing member of Holdings, may be deemed to control Holdings and, therefore, William J. Yung and Holdings may be deemed to have beneficial ownership and voting and dispositve control of all such Shares held of record by Holdings. In addition, Casuarina, the 1994 Trust, the 1998 Trust, Management, Joseph Yung and William J. Yung, may, pursuant to Rule 13d-5 of the Securities Act, be deemed to be the beneficial owner of the 2,598,100 Shares owned directly by Holdings. CASUARINA CAYMAN HOLDINGS, LTD. /s/ William J. Yung December 29, 1999 - -------------------------------- ----------------- **Signature of Reporting Person Date Name: William J. Yung Title: President **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 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 of 3 Joint Filer Information ----------------------- Designated Filer: Casuarina Cayman Holdings Ltd. Issuer and Ticker Symbol: Lodgian, Inc./LOD Date of Event Requiring Statement: December 20, 1999
Listing of Names and Addresses of Other Reporting Persons Signatures of Other Reporting Persons Date -------------------------- ------------------------------------- ---- Edgecliff Holdings, LLC EDGECLIFF HOLDINGS, LLC 207 Grandview Drive Fort Mitchell, KY 41017 By: /s/ William J. Yung 12/29/99 ------------------------------- -------- Name: William J. Yung Title: President Edgecliff Management, LLC EDGECLIFF MANAGEMENT, LLC 207 Grandview Drive Fort Mitchell, KY 41017 By: /s/ William J. Yung 12/29/99 ------------------------------- -------- Name: William J. Yung Title: President 1994 William J. Yung Family Trust 1994 WILLIAM J. YUNG FAMILY 207 Grandview Drive TRUST Fort Mitchell, KY 41017 By: The Fifth Third Bank, as Trustee By: /s/ Timothy A. Rodgers 12/29/99 -------------------------- -------- Name: Timothy A. Rodgers Title: Trust Officer Joseph Yung /s/ Joseph Yung 12/29/99 207 Grandview Drive ------------------------------------ -------- Fort Mitchell, KY 41017 Joseph Yung William J. Yung /s/ William J. Yung 12/29/99 1200 Cypress Street ------------------------------- -------- Cincinnati, OH 45206 The 1998 William J. Yung 1998 WILLIAM J. YUNG and Martha A. Yung Family Trust AND MARTHA A. YUNG FAMILY 207 Grandview Drive TRUST Fort Mitchell, KY 41017 By: The Fifth Third Bank, as Trustee By: /s/ Timothy A. Rodgers 12/29/99 ------------------------------- -------- Name: Timothy A. Rodgers Title: Trust Officer
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