4 1 l87666ae4.txt LODGIAN, INC./CASUARINA CAYMAN HOLDINGS FORM 4 1 U.S. 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 1. Name and Address of Reporting Person: Casuarina Cayman Holdings Ltd., 207 Grandview Drive, Fort Mitchell, KY 41017 2. Issuer Name and Ticker or Trading Symbol: Lodgian, Inc./LOD 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement of Month/Year: 3/01 5. If Amendment, Date of Original (Month/Year): 6. Relationship of Reporting Person to Issuer (Check all applicable): Director X 10% Owner ----- ----- Officer (give title below) Other (specify below) ----- ----- ================================================= 7. Individual or Joint/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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED 1. Title of Security 2. Transaction 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) Date action or Disposed of (D) Securities ship of In- Code (Instr. 3, 4 and 5) Beneficially Form; Direct (Month/ (Instr. 8) Owned at Direct Bene- Day/ ------------- -------------------------- End of (D) ficial Year) (A) Month Indirect Owner- Code V Amount or Price (Instr. 3 (I) ship (D) and 4) (Instr. 4) (Instr. 4) -------------------- -------------- ------------- -------------------------- --------------- -------------- ------------- Common Stock, 3/13/01 S 860,000 D $2.00 (1) (1) par value $0.01 per share Common Stock, 3/14/01 S 174,750 D $2.00 3,157,050 (1) (1) par value $0.01 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). 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 control number. 2
TABLE II-- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) 1. Title of Derivative 2. Conversion 3. Transaction 4. Transac- 5. Number of Deriv- 6. Date Exer- Security (Instr. 3) or Exercise Date tion Code Securities Ac- cisable and Ex- Price of (Instr. 8) quired (A) or Dis- piration Date Derivative posed of (D) Security (Month/ (Instr. 3, 4 and 5) (Month/Day/Year) Day/ Year) -------------- ----------------------- -------------------- Date Expira- Code V (A) (D) Exer- tion cisable Date --------------------------- --------------- --------------- --------------- ------------------------ -------------------- None. --------------------------- --------------- --------------- --------------- ------------------------ -------------------- 7. Title and Amount of 8. Price 9. Number 10. Ownership 11. Nature Underlying Securities Derivative of Derivative Form of Indirect Security Securities of Derivative Beneficial (Instr. 3 and 4) (Instr. 5) Beneficially Security: Ownership Owned Direct (Instr. 4) =========================== at End of (D) or Title Amount or Month Indirect (I) Number of (Instr. 4) (Instr. 4) Shares ------------ ------------ --------------- --------------- --------------- ------------------------ -------------------- ------------ ------------ --------------- --------------- --------------- ------------------------ --------------------
Explanation of Responses: (1) Casuarina Cayman Holdings Ltd. ("Casuarina") directly owns 1,593,700 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 1,593,700 Shares owned directly by Casuarina. Holdings directly owns 1,563,350 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 dispositive 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 1,563,350 Shares owned directly by Holdings. CASUARINA CAYMAN HOLDINGS LTD. /s/ William J. Yung April 10, 2001 ------------------------------- -------------- **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 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. 3 Joint Filer Information Designed Filer: Casuarina Cayman Holdings Ltd. Issuer and Ticker Symbol: Lodgian, Inc./LOD Statement of Month/Year: 3/01
Listing of Names and Addresses Of Other Reporting Persons Signatures of Other Reporting Persons Date ----------------------------------------- --------------------------------------- --------- Edgecliff Holdings, LLC EDGECLIFF HOLDINGS, LLC 4/10/01 207 Grandview Drive Fort Mitchell, KY 41017 By: /s/ William J. Yung ---------------------------- Name: William J. Yung Title: President Edgecliff Management, LLC EDGECLIFF MANAGEMENT, LLC 4/10/01 207 Grandview Drive Fort Mitchell, KY 41017 By: /s/ William J. Yung ---------------------------- Name: William J. Yung Title: President 1994 William J. Yung Family Trust 1994 WILLIAM J. YUNG FAMILY TRUST 4/10/01 207 Grandview Drive Fort Mitchell, KY 41017 By: The Fifth Third Bank, as Trustee By: /s/ Timothy A. Rodgers ---------------------------- Name: Timothy A. Rodgers Title: Trust Officer Joseph Yung /s/ Joseph Yung 4/10/01 207 Grandview Drive -------------------------- Fort Mitchell, KY 41017 Joseph Yung William J. Yung /s/ William J. Yung 4/10/01 1200 Cypress Street -------------------------- Cincinnati, OH 45206 William J. Yung The 1998 William J. Yung 1998 WILLIAM J. YUNG AND 4/10/01 and Martha A. Yung Family Trust MARTHA A. YUNG FAMILY TRUST 207 Grandview Drive Fort Mitchell, KY 41017 By: The Fifth Third Bank, as Trustee By: /s/ Timothy A. Rodgers ---------------------------- Name: Timothy A. Rodgers Title: Trust Officer