-----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, IPMPPZh7VhpNywtPXY2ACpD8Q2qzNN7w2uSRx0tzeJ0tA/OjrbikGbCYO2j469CD OaIJL4L+07e9in6uIeNyVg== 0001140361-04-006309.txt : 20041112 0001140361-04-006309.hdr.sgml : 20041111 20041112155618 ACCESSION NUMBER: 0001140361-04-006309 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041110 FILED AS OF DATE: 20041112 DATE AS OF CHANGE: 20041112 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: KATY INDUSTRIES INC CENTRAL INDEX KEY: 0000054681 STANDARD INDUSTRIAL CLASSIFICATION: SPECIAL INDUSTRY MACHINERY, NEC [3559] IRS NUMBER: 751277589 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 765 STRAITS TURNPIKE STREET 2: SUITE 2000 CITY: MIDDLEBURY STATE: CT ZIP: 06762 BUSINESS PHONE: 2035980397 MAIL ADDRESS: STREET 1: 765 STRAITS TURNPIKE STREET 2: SUITE 2000 CITY: MIDDLEBURY STATE: CT ZIP: 06762 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: JACOBI C MICHAEL CENTRAL INDEX KEY: 0001194836 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-05558 FILM NUMBER: 041139268 BUSINESS ADDRESS: STREET 1: C/O KATY INDUSTRIES INC STREET 2: 765 STRAITS TURNPIKE STE 2000 CITY: MIDDLEBURY STATE: CT ZIP: 06762 BUSINESS PHONE: 2035980397 MAIL ADDRESS: STREET 1: C/O KATY INDUSTRIES INC STREET 2: 765 STRAITS TURNPIKE STE 2000 CITY: MIDDLEBURY STATE: CT ZIP: 06762 4 1 doc1.xml FORM 4 X0202 4 2004-11-10 0 0000054681 KATY INDUSTRIES INC KT 0001194836 JACOBI C MICHAEL 358 TRANQUILITY ROAD MIDDLEBURY, CT X1 06762 1 1 0 0 President and CEO Common Stock 2004-11-10 2004-11-10 4 P 0 5000 4.50 A 9500 D Common Stock 2004-11-10 2004-11-10 4 P 0 5000 4.49 A 14500 D Common Stock 2004-11-11 2004-11-11 4 P 0 5000 4.50 A 19500 D Common Stock 2004-11-11 2004-11-11 4 P 0 5000 4.49 A 24500 D Mr. Jacobi has also been granted 1,050,000 options to purchase common stock and 125,000 shares of stock appreciation rights. Both transactions have been reported on previously filed Form 4s. /s/ Michael C. Paul at attorney-in-fact for C. Michael Jacobi 2004-11-12 -----END PRIVACY-ENHANCED MESSAGE-----