-----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, JorPdWI39sxHOytLnrecmawsictAlPd7ZXb2Ij6OyloK64IV+MtIklxPNzn1kraT kZlihoeEoSJ6vSQLrHDn3g== 0000950124-02-002028.txt : 20020610 0000950124-02-002028.hdr.sgml : 20020610 20020607163842 ACCESSION NUMBER: 0000950124-02-002028 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020531 FILED AS OF DATE: 20020607 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: DANIELSON HOLDING CORP CENTRAL INDEX KEY: 0000225648 STANDARD INDUSTRIAL CLASSIFICATION: FIRE, MARINE & CASUALTY INSURANCE [6331] IRS NUMBER: 956021257 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-06732 FILM NUMBER: 02673920 BUSINESS ADDRESS: STREET 1: 767 THIRD AVE 5TH FL CITY: NEW YORK STATE: NY ZIP: 10017 BUSINESS PHONE: 2128880347 MAIL ADDRESS: STREET 1: 767 THIRD AVE CITY: NEW YORK STATE: NY ZIP: 10017-2023 FORMER COMPANY: FORMER CONFORMED NAME: MISSION EQUITIES CORP DATE OF NAME CHANGE: 19770921 FORMER COMPANY: FORMER CONFORMED NAME: MISSION INSURANCE GROUP INC DATE OF NAME CHANGE: 19900826 COMPANY DATA: COMPANY CONFORMED NAME: ZELL SAMUEL CENTRAL INDEX KEY: 0001024193 DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: TWO N RIVERSIDE PLAZA SUITE 600 CITY: CHICAGO STATE: IL ZIP: 60606 BUSINESS PHONE: 3124540100 MAIL ADDRESS: STREET 1: TWO N RIVERSIDE PLAZA STREET 2: SUITE 600 CITY: CHICAGO STATE: IL ZIP: 60606 4 1 c70108be4.txt FORM 4 - ------ FORM 4 - ------ U.S. SECURITIES AND EXCHANGE COMMISSION [ ] Check box if no longer WASHINGTON, DC 20549 subject to Section 16. Form 4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP continue. See Instruction 1(b). 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. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person | | to Issuer (Check all applicable) Samuel Zell | Danielson Holding Corporation (DHC) | X Director X 10% Owner - -------------------------------------------------------------------------------------------| ----- ----- (Last) (First) (Middle) |3. IRS Identification | 4. Statement for | Officer (give title below) | Number of | Month/Year | ----- | Reporting Person, | | Other (specify below) | if an Entity | | ----- Two North Riverside Plaze, Suite 600 | (Voluntary) | May 2002 | - -----------------------------------------| |-------------------------|---------------------------------------- (Street) | | 5. If Amendment, |7. Individual or Joint/Group Filing | | Date of Original | (Check applicable line) | | (Month/Year) | X Form Filed by One Reporting Person Chicago, IL 60606 | | | -- - -----------------------------------------|-------------------------------------------------| Form Filed by More than One (City) (State) (Zip) | | -- Reporting Person | | - ------------------------------------------------------------------------------------------------------------------------------------ TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Security |2. Transaction| 3. Transaction|4. Securities Acquired (A)| 5. Amount of|6. Owner- |7. Nature (Instr. 3) | Date | Code | or Disposed of (D) | Securities | ship | of | | (Instr. 8) | (Instr. 3, 4 and 5) | Beneficially| Form: | Indirect | | | | Owned at End| Direct | Bene- | |---------------|--------------------------| of Month | (D) or | ficial | | | | |(A) | | (Instr. 3 | Indirect | Owner- | (Month/Day/ | | | | or | | and 4) | (I) | ship | Year) | Code | V | Amount |(D) | Price | |(Instr. 4)|(Instr. 4) - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|--------- |--------- Common Stock | 5/29/2002 | X | |1,560,174| A | $5.00 | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- Common Stock | 5/29/2002 | X | |1,900,437| A | $4.74 | 5,460,611 | I | (1) - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - --------------------------------------|--------------|-------|-------|---------|-----|----------|-------------|----------|--------- | | | | | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- 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). 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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of |6. Date Exer- |7. Title and Amount |8. Price Security | sion or | action | action | Derivative | cisable and | of Underlying | of (Instr. 3) | Exercise | Date | Code | Securities Ac- | Expiration | Securities | Deriv- | Price of | (Month/ | (Instr. 8)| quired (A) or | Date | (Instr. 3 and 4) | ative | Deriv- | Day/ | | Disposed of (D)| (Month/Day/ | | Secur- | ative | Year) | | (Instr. 3, 4, | Year) | | ity | Security | | | and 5) | | | (Instr. 5) | | | | |-------------------------------------| | | | | |Date |Expira- | | Amount or | | | |-------------------------------|Exer- |tion | Title | Number of | | | | Code |V | (A) |(D) |cisable|Date | | Shares | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | |Common | | | | | | | | | | |Stock | | Warrant to purchase | | | | | | | | |par | | common stock (right to | | | | | | | | |value | | buy)(1) | $4.74 |5/29/2002 | X | | |1,900,437|8/12/99|8/12/03 |$.10 |1,900,437 | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | |Common | | | | | | | | | | |Stock | | | | | | | | | | |par | | Common stock option | | | | | | | | |value | | (right to buy)(2) | $3.37 |12/11/2001| J (2) | | 155,000| |6/11/02|12/11/11|$.10 | 155,000 | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ - -------------------------------------------------------------------------- 9. Number of | 10. Ownership Form | 11. Nature of Derivative | of Derivative | Indirect Securities | Securities | Beneficial Beneficially | Beneficially | Ownership Owned at End | owned at end | (Instr. 4) of Month | of month | (Instr. 4) | (Instr. 4) | - ------------------|------------------------|------------------------------ 155,000 | I | (2) - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - -------------------------------------------------------------------------- Explanation of Responses: /s/ SAMUEL ZELL 06/06/2002 ----------------------------------------- ---------- Signature of Reporting Person** Date (1) The stock purchase warrant ("Warrant") and the shares of Common Stock, including shares of Common Stock issued upon exercise of the Warrant, are beneficially owned by SZ Investments, L.L.C., a Delware limited liability company ("SZ Investments"). Certain of the indirect members of members of SZ Investments are trusts created for the benefit of the reporting person and members of his family. (2) The stock option agreement ("Option") was issued to Equity Group Investments, L.L.C. ("EGI") under the Issuer's 1995 Stock and Incentive Plan in consideration for services rendered or to be rendered to the Issuer. Certain of the direct and indirect beneficial owners of EGI are trusts created for the benefit of the reporting person and members of his family. 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). ** 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. 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. Page 2 of 2
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