-----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, Wu/bf+9NHKiPXEy5f5miPOcuN+ymS02NXT39LWmJ+CVqWAZ2BEO9mHBhb6YzXY7R dBrMpGxhT+ZG2cbXbmYrRw== 0000950144-98-014052.txt : 19981222 0000950144-98-014052.hdr.sgml : 19981222 ACCESSION NUMBER: 0000950144-98-014052 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981211 FILED AS OF DATE: 19981221 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: 98773048 BUSINESS ADDRESS: STREET 1: 1601 BELVEDERE RD CITY: WEST PALM BEACH STATE: FL ZIP: 33406 BUSINESS PHONE: 5616899970 MAIL ADDRESS: STREET 1: 1601 BELVEDERE RD CITY: WEST PALM BEACH STATE: FL ZIP: 33406 COMPANY DATA: COMPANY CONFORMED NAME: COLE ROBERT S CENTRAL INDEX KEY: 0001075595 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR STATE OF INCORPORATION: GA FILING VALUES: FORM TYPE: 3 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 3 1 LODGIAN, INC. FORM 3 FOR ROBERT COLE 1 - -------- FORM 3 - -------- U.S. 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(f) of the Investment Company Act of 1940 - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Date of Event Requiring 4. Issuer Name and Ticker or 6. If Amendment, Date Cole Robert S. Statement Trading Symbol of Original - ---------------------------------------- (Month/Day/Year) Lodgian, Inc. (LOD) (Month/Day/Year) (Last) (First) (Middle) 12/11/98 ---------------------------------- 4270 River Bottom Drive ---------------------------- 5. Relationship of Reporting ----------------------- - ---------------------------------------- 3. IRS or Social Security Person to Issuer 7. Individual or Joint/ (Street) Number of Reporting (Check all applicable) Group Filing (Check Norcross GA 30092 Person (Voluntary) X Director 10% Owner applicable line) - -------------------------------------- ###-##-#### ----- ----- X Form filed by (City) (State) (Zip) ---------------------------- X Officer Other ----- One Reporting ----- (give ----- (specify Person title below) below) Form filed by ----- More than One ---------------------------------- Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect (Instr. 4) Beneficially Owned Direct (D) or Beneficial (Instr. 4) Indirect (I) Ownership (Instr. 4) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 534,188.72 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ *If the form is filed by more than one Reporting Person, see Instruction 4(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) (Print or Type Responses) (8/96)
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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 3. Title and Amount of 4. Conver- 5. Owner- 6. Nature of Indirect (Instr. 4) Exercisable and Securities Underlying sion or ship Beneficial Ownership Expiration Date Derivative Security Exercise Form of (Instr. 5) (Month/Day/ (Instr. 4) Price of Deriv- Year) Deri- ative vative Security: Security Direct ------------------------------------------------- (D) or Date Expira- Amount or Indirect Exercis- tion Title Number (I) able Date of Shares (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Option to purchase Common Stock 12/11/99 12/11/08 Common Stock 37,000 $6.125/Share D - ------------------------------------------------------------------------------------------------------------------------------------ Option to purchase Common Stock 12/11/00 12/11/08 Common Stock 37,000 $6.125/Share D - ------------------------------------------------------------------------------------------------------------------------------------ Option to purchase Common Stock 12/11/01 12/11/08 Common Stock 37,000 $6.125/Share D - ------------------------------------------------------------------------------------------------------------------------------------ Option to purchase Common Stock 12/11/02 12/11/08 Common Stock 37,000 $6.125/Share D - ------------------------------------------------------------------------------------------------------------------------------------ Option to purchase Common Stock 12/11/03 12/11/08 Common Stock 37,000 $6.125/Share D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: /s/ ROBERT S. COLE December 21, 1998 **Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- ------------------ Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date Note. File three copies of this form, one of which must be manually signed. Page 2 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 the form displays a currently valid OMB Number. (Print or Type Responses)
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