-----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, MU6NpycRPgUXg1tmb844sT+G3/EDPLdZnRZ4soQRpliU0ddF5Le1fqi8qtO+N8jT tEC8sUIeUTdccxfAo5iK4Q== 0000950142-03-000345.txt : 20030224 0000950142-03-000345.hdr.sgml : 20030224 20030224155000 ACCESSION NUMBER: 0000950142-03-000345 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030224 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: DEESE JERRY E CENTRAL INDEX KEY: 0001132435 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: C/O FAB INDUSTRIES STREET 2: 200 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10016 BUSINESS PHONE: 2125922700 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FAB INDUSTRIES INC CENTRAL INDEX KEY: 0000034136 STANDARD INDUSTRIAL CLASSIFICATION: KNITTING MILLS [2250] IRS NUMBER: 132581181 STATE OF INCORPORATION: DE FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05901 FILM NUMBER: 03577623 BUSINESS ADDRESS: STREET 1: 200 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10016 BUSINESS PHONE: 2122799000 MAIL ADDRESS: STREET 1: 200 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10016 5 1 form5deese_022403.txt STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0362 Expires: January 31, 2005 Estimated average burden hours per response ....... 1.0 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check this box if no longer subject to Section 16. Form 4 or form 5 obligations may continue. See Instruction 1(b). [_] Form 3 Holdings Reported [X] Form 4 Transactions Reported - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Deese Jerry E. - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Fab Industries, Inc., 200 Madison Avenue - -------------------------------------------------------------------------------- (Street) New York NY 10016 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Fab Industries, Inc. ("FIT") - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year 12/31/02 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [_] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) Vice President/Controller of Plant Operations - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check Applicable Line) [X] Form filed by One Reporting Person [_] Form filed by More than One Reporting Person - -------------------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. 6. 2A. 4. Amount of Owner- Deemed Securities Acquired (A) or Securities ship 2. Execution 3. Disposed of (D) Beneficially Form: 7. Transaction Date, Transaction (Instr. 3, 4 and 5) Owned at End Direct Nature of Date if any Code ------------------------------ of Issuer's (D) or Indirect 1. (Month/ (Month/ (Instr. 8) (A) Fiscal Year Indirect Beneficial Title of Security Day/ Day/ ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) Year) Year) Code (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $0.20 per share 5/30/02 M4 10,000 A $13.00 - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $0.20 per share 5/30/02 M4 2,000 A $11.06 12,200 D - ------------------------------------------------------------------------------------------------------------------------------------ 888 I By ESOP - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the form is filed by more than one reporting person, see Instruction 4(b)(v). 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 CONTROL NUMBER. (Over) SEC 2270 (9/02) FORM 5 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or 3A. Derivative 6. of Underlying 8. ities Secur- of Exer- Deemed Securities Date Securities Price Bene- ity: In- cise 3. Execu- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- tion 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Date, Trans- of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date if any action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr (Instr. 3) ity Year) Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Option (right to buy) $13.00 5/30/02 M4 10,000 (1) 10/27/09 Common Stock 10,000 -0- D - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Option (right to buy) $11.06 5/30/02 M4 2,000 (2) 11/03/10 Common Stock 2,000 -0- D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: (1) 2,000 shares became exercisable on each of 10-27-00 and 10-27-01, and the remaining 6,000 shares became exercisable on 5-30-02 when all outstanding options under the issuer's 1997 Stock Incentive Plan became vested immediately following stockholder approval of the Fab Industries, Inc. Plan of Liquidation and Dissolution. (2) 400 shares became exercisable on 11-03-01, and the remaining 1,600 shares became exercisable on 5-30-02 when all outstanding options under the issuer's 1997 Stock Incentive Plan became vested immediately following stockholder approval of the Fab Industries, Inc. Plan of Liquidation and Dissolution. /s/ Jerry E. Deese February 24, 2003 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----