FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
DIEBOLD INC [ DBD ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 06/30/2005 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock(1) | 8,205 | D | ||||||||
Common Stock(1) | 2,000 | I | By Spouse(2) | |||||||
Common Stock(1) | 1,000 | I | By Spouse's IRA(2) | |||||||
Common Stock(1) | 33,097 | I | By self as Advisor to Trustee(3) | |||||||
Common Stock(1) | 80,000 | I | By self as Co-Trustee(4) | |||||||
Common Stock(1) | 1,000 | I | By self as Co-Trustee(2)(5) | |||||||
Common Stock(1) | 1,000 | I | By self as Co-Trustee(2)(6) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Option to Buy(1) | $29.91 | 04/26/2004 | 04/25/2006 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $29.91 | 04/26/2005 | 04/25/2006 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $38.64 | 04/25/2003 | 04/24/2012 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $38.64 | 04/25/2004 | 04/24/2012 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $38.64 | 04/25/2005 | 04/24/2012 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $38.64 | 07/01/2005(7) | 04/24/2012 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $39.26 | 04/24/2004 | 04/24/2013 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $39.26 | 04/24/2005 | 04/24/2013 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $39.26 | 07/01/2005(7) | 04/24/2013 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $39.26 | 07/01/2005(7) | 04/24/2013 | Common Stock | 1,000 | 1,000 | D | ||||||||
Option to Buy(1) | $49.24 | 04/22/2005 | 04/22/2014 | Common Stock | 1,125 | 1,125 | D | ||||||||
Option to Buy(1) | $49.24 | 07/01/2005(7) | 04/22/2014 | Common Stock | 3,375 | 3,375 | D |
Explanation of Responses: |
1. This form is being filed for the sole purpose of informing the market that the reporting person has terminated his insider status due to retirement from the Board of Directors, effective June 30, 2005. The reported holdings reflect the reporting person's beneficial ownership as of the date of termination of service. |
2. The undersigned disclaims any beneficial ownership. |
3. By self as Advisor to Trustee for W.R. Timken, Jr. Revocable Trust |
4. By self as Co-Trustee for Trust Under Will of H.H. Timken, Jr. |
5. By self as Co-Trustee for W.R. Timken Trust FBO Kristin T. Kingery's Children |
6. By self as Co-Trustee of W.R. Timken Trust FBO Great-Grandchildren |
7. All options that were previously unvested, vested upon retirement from the Board of Directors on June 30, 2005. Options that were granted on April 28, 2005 were forfeited due to retirement less than six months after the date of the grant. |
Remarks: |
W.R. Timken, Jr. | 07/05/2005 | |
** 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 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. | ||
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. |