-----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, WR2CcsCdBuFRNvNQc8HkKYT0H4IhrzvEH6nNPV+bmKOJu4GcUYmE4m8DhG4rpPoe x5vYzAkoBr6h07LyMAnHmQ== 0001288043-04-000024.txt : 20041208 0001288043-04-000024.hdr.sgml : 20041208 20041208183149 ACCESSION NUMBER: 0001288043-04-000024 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041206 FILED AS OF DATE: 20041208 DATE AS OF CHANGE: 20041208 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: 041191759 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 2004-12-06 0 0000029332 DIXIE GROUP INC DXYN 0001196587 DAVIS W DEREK 2208 S. HAMILTON ST. DALTON GA 30721 0 1 0 0 VP - Human Resources Employee Stock Option (right to buy) 15.98 2004-12-06 4 A 0 5510 A 2005-06-06 2010-12-06 Common Stock, $3 par value 5510 5510 D Employee Stock Option (right to buy) 15.98 2004-12-06 4 A 0 1160 A 2005-06-06 2010-12-06 Common Stock, $3 par value 1160 6670 D The reported transaction represents an incentive stock option granted under the Issuer's Stock Incentive Plan. The reported transaction represents a non-qualified stock option granted under the Issuer's Stock Incentive Plan. John F. Henry, Jr., by power of attorney for W. Derek Davis 2004-12-08 -----END PRIVACY-ENHANCED MESSAGE-----