SEC Form 3
FORM 3 UNITED STATES 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
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Stephenson Keith Dwayne

(Last) (First) (Middle)
39550 ORCHARD HILL PLACE

(Street)
NOVI MI 48375

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
03/21/2011
3. Issuer Name and Ticker or Trading Symbol
Cooper-Standard Holdings Inc. [ COSH ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
Chief Operating Officer
5. If Amendment, Date of Original Filed (Month/Day/Year)
03/21/2011
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock options(1) 03/15/2014 03/15/2021 Common stock 13,000 $46.75 D
7% Cumulative Participating Convertible Preferred Stock(2) (3)(4) (5) Common stock 3,175 $23.3057 D
Explanation of Responses:
1. Due to an administrative error, the Form 3 filed on March 21, 2011, omitted 13,000 stock options that were granted on March 15, 2011. These are time-based options which shall vest, assuming continued employment, on March 15, 2014. These options are in addition to those 104,941 options that were reported on 3/21/11 and have a different exercise date, expiration date and exercise price.
2. Due to an administrative error, the Form 3 filed on March 21, 2011, omitted 33 shares of paid-in-kind dividends of 7% Cumulative Participating Convertible Preferred Stock.
3. These shares of participating preferred common stock are entitled to receive dividends at a rate of 7% per annum and may be converted at any time at a conversion price of $23.30574 per share of common stock, subject to adjustment upon certain events specified in the certificate of designation.
4. Time-based restricted stock vesting in four equal installments on May 27, 2011, May 27, 2012, May 27, 2013, and May 27, 2014.
5. The 7% Cumulative Participating Convertible Preferred stock do not have an expiration date.
/s/ Keith D. Stephenson 04/08/2011
** Signature of Reporting Person Date
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 5 (b)(v).
** 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.
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