-----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, Q26xifRgNs8P+W47MquNIZi3NPYELKCidRcHRTXVbpcl49zNH83sscqkDnGUinmX 7cYV3wCCvy7Sq6p1cgca7w== /in/edgar/work/0000912057-00-047634/0000912057-00-047634.txt : 20001108 0000912057-00-047634.hdr.sgml : 20001108 ACCESSION NUMBER: 0000912057-00-047634 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000901 FILED AS OF DATE: 20001107 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEI INC CENTRAL INDEX KEY: 0000351298 STANDARD INDUSTRIAL CLASSIFICATION: [3674 ] IRS NUMBER: 410944876 STATE OF INCORPORATION: MN FISCAL YEAR END: 0831 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-10078 FILM NUMBER: 754745 BUSINESS ADDRESS: STREET 1: 1495 STEIGER LAKE LN STREET 2: P O BOX 5000 CITY: VICTORIA STATE: MN ZIP: 55386 BUSINESS PHONE: 9524432500 MAIL ADDRESS: STREET 1: P O BOX 5000 STREET 2: 1495 STEIGER LAKE LANE CITY: VICTORIA STATE: MN ZIP: 55386 COMPANY DATA: COMPANY CONFORMED NAME: PETERSEN STEPHEN KEITH CENTRAL INDEX KEY: 0001127852 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OTHER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 1495 STEIGER LAKE LANE CITY: VICTORIA STATE: MN ZIP: 55386 BUSINESS PHONE: 9524437090 MAIL ADDRESS: STREET 1: 1495 STEIGER LAKE LANE CITY: VICTORIA STATE: MN ZIP: 55386 3 1 a2029623z3.txt FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Petersen Stephen Keith - -------------------------------------------------------------------------------- (Last) (First) (Middle) 1495 Steiger Lake Lane - -------------------------------------------------------------------------------- (Street) Victoria MN 55386 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Date of Event Requiring Statement (Month/Day/Year) 09/01/00 - -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name and Ticker or Trading Symbol HEI, Inc. (HEII) - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) Vice President Operations - -------------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) - -------------------------------------------------------------------------------- 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 Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock $.05 per value 2,408 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print of Type Responses) (Over) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Options 2/24/00 2/24/09 Common Stock 2,250 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ 2/24/01 2/24/09 2,250 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ 2/24/02 2/24/09 2,250 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ 2/24/03 2/24/09 2,250 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ (1) 2/24/09 4,500 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ (2) 2/24/09 4,500 5.875 D - ------------------------------------------------------------------------------------------------------------------------------------ 12/6/01 12/6/09 1,250 6.4375 D - ------------------------------------------------------------------------------------------------------------------------------------ 1/20/01 1/20/10 1,875 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ 1/20/02 1/20/10 1,875 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ 1/20/03 1/20/10 1,875 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ 1/20/04 1/20/10 1,875 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Options (3) 1/20/10 3,750 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ (4) 1/20/10 3,750 10.75 D - ------------------------------------------------------------------------------------------------------------------------------------ 2/6/02 2/06/10 1,250 10.938 D ====================================================================================================================================
Explanation of Responses: (1) The option will become exercisable when the closing price has equaled or exceeded $9.00 for at least five consecutive trading days. (2) The option will become exercisable when the closing price has equaled or exceeded $25.00 for at least five consecutive trading days. (3) The option will become exercisable when the closing price has equaled or exceeded $15.00 for at least five consecutive trading days. (4) The option will become exercisable when the closing price has equaled or exceeded $25.00 for at least five consecutive trading days. /s/ Stephen Keith Petersen November 7, 2000 - --------------------------------------------- ----------------------- **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. -----END PRIVACY-ENHANCED MESSAGE-----