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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 01/08/2004 |
3. Issuer Name and Ticker or Trading Symbol
CROSS A T CO [ ATX ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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) |
Class A Common Stock | 1,736,777 | I | See Footnote 1(1) |
Class B Common Stock | 1,804,800 | I | See Footnote 2(2) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 |
Explanation of Responses: |
1. The reporting person beneficially owns 1,010,777 shares of the issuer's Class A common stock of which (i) 19,931 shares are held direclty by the reporting person, (ii) 159,846 shares are held by the reporting person's spouse and (iii) 831,000 shares are held in a trust of which the reporting person is co-trustee and the reporting person's spouse is a beneficiary. The reporting person disclaims any beneficial interest in 726,000 shares held in a trust of which the reporting person's brother-in-law is a beneficiary. |
2. The reporting person beneficially owns 902,400 shares of the issuer's Class B common stock which are held in a trust of which the reporting person is co-trustee and the reporting person's spouse is a beneficiary. The reporting person disclaims any beneficial interest in 902,400 shares which are held in a trust of which the reporting person's brother-in-law is a beneficiary. |
Margaret D. Farrell (Attorney-in-fact for Marjorie B. Boss) | 02/12/2004 | |
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |