-----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, VaPuMx4IC5xHBEhBDmKUqw7nXlKwfde7QPDm/EktgM08eqAJ0mVGTkRgSZ57ipm2 30zD8GzVq0qEdYDtZDC5fg== 0001196610-04-000003.txt : 20040510 0001196610-04-000003.hdr.sgml : 20040510 20040510174006 ACCESSION NUMBER: 0001196610-04-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040505 FILED AS OF DATE: 20040510 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: 2208 S. HAMILTON STREET CITY: DALTON STATE: GA ZIP: 307214974 BUSINESS PHONE: 7068765851 MAIL ADDRESS: STREET 1: 2208 S. HAMILTON STREET CITY: DALTON STATE: GA ZIP: 307214974 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: 04794395 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 X0202 4 2004-05-05 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, $3.00 Par Value 2004-05-05 4 M 0 5000 4.875 A 19308 D Common Stock, $3.00 Par Value 2004-05-05 4 M 0 6000 5.75 A 25308 D Common Stock, $3.00 Par Value 2004-05-05 4 S 0 11000 12.9 D 14308 D Common Stock, $3.00 Par Value 2004-05-10 4 M 0 6000 5.75 A 20308 D Common Stock, $3.00 Par Value 2004-05-10 4 S 0 4800 12.4527 A 15508 D Common Stock, $3.00 Par Value 2004-05-10 4 S 0 1200 12.58 A 14308 D Employee Stock Option (Right to Buy) 4.875 2004-05-05 4 M 0 5000 0 D 2006-08-22 Common Stock, $3.00 Par Value 5000 0 D Employee Stock Option (Right to Buy) 5.75 2004-05-05 4 M 0 6000 0 D 2006-11-15 Common Stock, $3.00 Par Value 6000 6000 D Employee Stock Option (Right to Buy) 5.75 2004-05-10 4 M 0 6000 0 D 2006-11-15 Common Stock, $3.00 Par Value 6000 0 D The option vested in four equal annual installments of 1,250 shares each, commencing on 8/22/98, 8/22/99, 8/22/00, and 8/22/01, respectively. The option vested in four equal annual installments of 3,000 each, commencing on 11/15/98, 11/15/99, 11/15/00, and 11/15/01, respectively. Includes 3,281 shares allocated to the Reporting Person's account under the Issuer's 401(k) Plan. John F. Henry, Jr., by power of attorney for W. Derek Davis 2004-05-10 -----END PRIVACY-ENHANCED MESSAGE-----