-----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, AvKFUBFtKy+sW19GEP4pyelS4nxQa6mO4lTJ/uaDa20Ulcl7ANpaJsHCN9fQRC4j Hxz6EjUNS1ogGVCmw4nVPg== 0000894579-10-000196.txt : 20101116 0000894579-10-000196.hdr.sgml : 20101116 20101116171823 ACCESSION NUMBER: 0000894579-10-000196 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20101115 FILED AS OF DATE: 20101116 DATE AS OF CHANGE: 20101116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BRUCKMANN BRUCE CENTRAL INDEX KEY: 0001083166 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-52013 FILM NUMBER: 101197408 MAIL ADDRESS: STREET 1: C/O MOHAWK INDUSTRIES INC STREET 2: P O BOX 12069 CITY: CALHOUN STATE: GA ZIP: 30703 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: TOWN SPORTS INTERNATIONAL HOLDINGS INC CENTRAL INDEX KEY: 0001281774 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MEMBERSHIP SPORTS & RECREATION CLUBS [7997] IRS NUMBER: 200640002 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 5 PENN PLAZA STREET 2: 4TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10001 BUSINESS PHONE: (212) 246-6700 MAIL ADDRESS: STREET 1: 5 PENN PLAZA STREET 2: 4TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10001 4 1 edgar.xml PRIMARY DOCUMENT X0303 4 2010-11-15 0001281774 TOWN SPORTS INTERNATIONAL HOLDINGS INC CLUB 0001083166 BRUCKMANN BRUCE C/O BRUCKMANN, ROSSER, SHERRILL & CO. 126 EAST 56TH STREET, 29TH FLOOR NEW YORK NY 10022 1 0 0 0 Common Stock, par value $0.001 2010-11-15 4 J 0 1770379 0 D 0 I By BRSE Associates, Inc. Common Stock, par value $0.001 2010-11-15 4 J 0 531114 0 A 942432 D Common Stock, par value $0.001 354077 I By Trust Common Stock, par value $0.001 8238 I By BCB Family Partners, L.P. Common Stock, par value $0.001 3975 I By NAZ Family Partners, L.P. Common Stock, par value $0.001 5747 I By Nancy A. Zweng On November 15, 2010, BRSE Associates, Inc. ("BRSE") distributed all of its shares of common stock of Town Sports International Holdings, Inc. pro rata to its stockholders. The Reporting Person is a stockholder and officer of BRSE. The Reporting Person received these shares in the distribution described in footnote (1) above. These shares are held in a trust for the benefit of the Reporting Person's children. The Reporting Person's former spouse is the trustee of the trust. The Reporting Person disclaims beneficial ownership of these shares. These shares are held by BCB Family Partners, L.P., of which the Reporting Person is the general partner. The Reporting Person may be deemed to share beneficial ownership of shares held by NAZ Family Partners, L.P. by virtue of his holding power of attorney for NAZ Family Partners, L.P. The Reporting Person disclaims beneficial ownership of any shares held by NAZ Family Partners, L.P. The Reporting Person may be deemed to share beneficial ownership of shares held by Nancy A. Zweng by virtue of his holding power of attorney for Nancy A. Zweng. The Reporting Person disclaims beneficial ownership of any shares held by Nancy A. Zweng. /s/ David M. Kastin, Attorney-in-Fact 2010-11-15 -----END PRIVACY-ENHANCED MESSAGE-----