5 1 wcj_form521103.txt FORM 5 ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0362 Expires: January 31, 2005 Estimated average burden hours per response.........1.0 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 5 ANNUAL 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(h) of the Investment Company Act of 1940 |_| Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |_| Form 3 Holdings Reported |X| Form 4 Transactions Reported ________________________________________________________________________________ 1. Name and Address of Reporting Person* Johnsen Walter C. -------------------------------------------------------------------------------- (Last) (First) (Middle) 1931 Black Rock Turnpike -------------------------------------------------------------------------------- (Street) Fairfield CT 06825 -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Acme United Corporation (ACU) ________________________________________________________________________________ 3. I.R.S. Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Year December 31, 2002 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) |X| Director |X| 10% Owner |X| Officer (give title below) |_| Other (specify below) President and Chief Executive Officer ________________________________________________________________________________ 7. 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 Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) Securities ship 2A. or Disposed of (D) Beneficially Form: 7. 2. Deemed (Instr. 3, 4 and 5) Owned Direct Nature of Trans- Execution 3. --------------------------- at the End (D) or Indirect 1. action Date, if Transaction (A) of Issuer's Indirect Beneficial Title of Security Date any Code or Fiscal Year (I) Ownership (Instr. 3) (mm/dd/yy) (mm/dd/yy) (Instr. 8) Amount (D) Price (Instr. 3 & 4) (Instr.4) (Instr.4) --------------------------------------------------------------------------------------------------------------------------------- Common Stock 277,272 *see below --------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- Note: Adjust for addition error - increase shares by 1,000. ================================================================================================================================= Note: Adjust for addition error - increase shares by 1,000.
* If the form is filed by more than one reporting person, see instruction 4(b)(v). Persons who respond to the collection of information contained in this form are not required to respond unless the form diplays a currently valid OMB control number. (Over) SEC 2270 (09-02) FORM 5 (continued) ================================================================================ Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship 2. of of Conver- 5. 7. Deriv- Deriv- 11. sion Number of Title and Amount ative ative Nature or Derivative 6. of Underlying 8. Secur- Secur- of Exer- 3A. Securities Date Securities Price ities ity: In- cise Deemed Acquired (A) Exercisable and (Instr. 3 and 4) of Bene- Direct direct Price 3. Execut- 4. or Disposed Expiration Date ---------------- Deriv- ficially (D) or Bene- 1. of Trans- ion Trans- of(D) (Month/Day/Year) Amount ative Owned In- ficial Title of Deriv- action Date if action (Instr. 3, ---------------- or Secur- at End direct Owner- Derivative ative Date any Code 4 and 5) Date Expira- Number ity of Year (I) ship Security Secur- (mm/dd/ (mm/dd/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity yy) yy) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 2.1250 1/26/1999 A5* 30,000 1/26/02 1/26/09 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 2.1250 6/22/1999 A5* 10,000 6/22/02 6/22/09 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 1.6250 1/25/2000 A5* 10,000 (a) 1/25/10 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 2.3750 4/21/2000 A5* 30,000 (b) 4/21/10 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 3.5600 10/10/2000 A5* 10,000 (c) 10/10/10 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 2.7500 5/07/2001 A5* 25,000 (d) 5/07/11 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ Stock Common Option 3.0500 11/21/2001 A5* 25,000 (e) 11/21/11 Stock 290,000 D ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: (a) 2,500 shares vested on January 25, 2000, 2,500 shares vested on January 25, 2001, 2,500 shares vested on January 25, 2002 and 2,500 vested on January 25, 2003. (b) 7,500 shares vested on April 21, 2000, 7,500 shares vested on April 21,2001, 7,500 shares vested on April 21, 2002 and 7,500 will vest on April 21, 2003. (c) 2,500 shares vested on October 10, 2000, 2,500 shares vested on October 10, 2001, 2,500 shares vested on October 10, 2002 and 2,500 will vest on October 10, 2003. (d) 6,250 shares vested on May 7, 2001, 6,250 shares vested on May 7, 2002, 6,250 shares will vest on May 7, 2003 and 6,250 will vest on May 7, 2004. (e) 6,250 shares vested on November 21, 2001, 6,250 shares vested on November 21, 2002, 6,250 shares will vest on November 21, 2003 and 6,250 will vest on November 21, 2004.
/s/ Walter C. Johnsen February 6, 2003 --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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. Persons who respond to the collection of information contained in this form are not required to respond unless the form diplays a currently valid OMB control number.