-----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, Navnba6iVKyav/6Qv/sMCrPEnaqLMOshApYXxcIxeNEsrJYtyhT6pd3+RYTGaSfg T2isdYxT08ZR8oPs+o2Kkw== 0001196587-03-000001.txt : 20031219 0001196587-03-000001.hdr.sgml : 20031219 20031219155109 ACCESSION NUMBER: 0001196587-03-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031218 FILED AS OF DATE: 20031219 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: DIXIE GROUP INC CENTRAL INDEX KEY: 0000029332 STANDARD INDUSTRIAL CLASSIFICATION: CARPETS AND RUGS [2273] IRS NUMBER: 620183370 STATE OF INCORPORATION: TN FISCAL YEAR END: 1225 BUSINESS ADDRESS: STREET 1: P O BOX 12542 CITY: CALHOUN STATE: GA ZIP: 307037010 BUSINESS PHONE: 7066257980 MAIL ADDRESS: STREET 1: P O BOX 12542 CITY: CALHOUN STATE: GA ZIP: 307037010 FORMER COMPANY: FORMER CONFORMED NAME: DIXIE YARNS INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: DIXIE MERCERIZING CO DATE OF NAME CHANGE: 19670524 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DAVIS W DEREK CENTRAL INDEX KEY: 0001196587 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-02585 FILM NUMBER: 031065224 BUSINESS ADDRESS: STREET 1: 736 MARKET ST STREET 2: STE 1100 CITY: CHATTANOOGA STATE: TN ZIP: 37402 BUSINESS PHONE: 423 265 8881 MAIL ADDRESS: STREET 1: 185 S INDUSTRIAL BLVD CITY: CALHOUND STATE: GA ZIP: 30701 4 1 primary_doc.xml PRIMARY DOCUMENT X0201 4 2003-12-18 0 0000029332 DIXIE GROUP INC dxyn 0001196587 DAVIS W DEREK 185 S INDUSTRIAL BLVD CALHOUND GA 30701 0 1 0 0 V.P. of Human Resources Common Stock, $3 Par Value 2003-12-18 4 J 0 18174 D 28797 D Represents the cancellation by the Issuer of subscriptions by the Reporting Person for 18,174 shares under the Issuer's Stock Ownership Plan. Includes 3,281 shares allocated to the Reporting Person's account under the Issuer's 401(k) Plan. Also includes 20,000 shares for which the Reporting Person has subscribed, but has not yet purchased, under the Issuer's Stock Ownership Plan. John F. Henry, Jr. for W. Derek Davis 2003-12-19 -----END PRIVACY-ENHANCED MESSAGE-----