-----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, RjoARdWsdgWzAMFISxDRNslFhKvgHvitp7GtAOjrEFx++PsppJCs5VzSQl3k87h0 HYAHvGZQPlpismIj6H+tBw== 0000950144-01-501720.txt : 20010510 0000950144-01-501720.hdr.sgml : 20010510 ACCESSION NUMBER: 0000950144-01-501720 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010430 FILED AS OF DATE: 20010509 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PIERRE FOODS INC CENTRAL INDEX KEY: 0000067494 STANDARD INDUSTRIAL CLASSIFICATION: BAKERY PRODUCTS [2050] IRS NUMBER: 560945643 STATE OF INCORPORATION: NC FISCAL YEAR END: 0306 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-07277 FILM NUMBER: 1626229 BUSINESS ADDRESS: STREET 1: 9990 PRINCETON RD CITY: CINCINNATI STATE: OH ZIP: 45246 BUSINESS PHONE: 8283040027 MAIL ADDRESS: STREET 1: 9990 PRINCETON RD CITY: CINCINNATI STATE: OH ZIP: 45246 FORMER COMPANY: FORMER CONFORMED NAME: FRESH FOODS INC DATE OF NAME CHANGE: 19980513 FORMER COMPANY: FORMER CONFORMED NAME: WSMP INC DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: WESTERN STEER MOM N POPS INC DATE OF NAME CHANGE: 19880719 COMPANY DATA: COMPANY CONFORMED NAME: CLARK DAVID R CENTRAL INDEX KEY: 0001068000 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: PO BOX 399 CITY: CLAREMONT STATE: NC ZIP: 28610 BUSINESS PHONE: 8284593117 MAIL ADDRESS: STREET 1: PO BOX 399 CITY: CLAREMONT STATE: NC ZIP: 28610 4 1 g69087be4.txt PIERRE FOODS INC/CLARK 1 - ------ FORM 4 - ------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check this box if no longer subject to Filed pursuant to Section 16(a) of the Securities Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the or Form 5 obligations Public Utility Holding Company Act of 1935 may continue. See or Section 30(f) of the Investment Company Instruction 1(b). Act of 1940 (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ | 1. Name and Address of Reporting Person* | 2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person(s)| | Clark David R. | Pierre Foods, Inc. (Nasdaq: FOOD) | to Issuer (Check all applicable) | |--------------------------------------------|----------------------------------------------| | | (Last) (First) (Middle) | 3. IRS Identification | 4. Statement For | [X] Director [X] 10% Owner | | | Number of Reporting | Month/Year | [X] Officer (give [ ] Other (Specify| | | Person, if an Entity | | title below) | | 361 Second Street, N.W., P.O. Box 3967 | (Voluntary) | | below) | | | | April 2001 | Vice Chairman of the Board | |--------------------------------------------| |--------------------|--------------------------------------| | (Street) | | 5. If Amendment, |7. Individual or Joint/Group Reporting| | | | Date of Original| (Check applicable line) | | | | (Month/Year) | [X] Form Filed by One | | Hickory North Carolina 28603 | | | Reporting Person | |--------------------------------------------|----------------------------------------------| [ ] Form Filed by More Than | | (City) (State) (Zip) | | One Reporting Person | | | | | |----------------------------------------------------------------------------------------------------------------------------------| | TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED | |----------------------------------------------------------------------------------------------------------------------------------| |1. Title of Security |2. Transaction |3. Transac- |4. Securities Acquired (A) |5. Amount of Se- |6. Owner- |7. Nature | | (Instr. 3) | Date | tion Code | or Disposed of (D) | curities Benefi-| ship | of In- | | | (Month/Day/ | (Instr. 8) | | cially Owned at | Form: | direct | | | Year) | | | End of Month | Direct | Benefi-| | | | | (Instr. 3, 4 and 5) | (Instr. 3 and 4)| (D) or | cial | | | |--------------|--------------------------- | | Indirect | Owner- | | | | Code | V | Amount | (A) or| Price | | (I) | ship | | | | | | | (D) | | | (Instr. 4)| (Instr.| | | | | | | | | | | 4) | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 288,462 | A |$7.50(1)| | I |By PFMI(2)| |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 9,766 | A |$7.50(3)| | I |By PFMI | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 24,396 | A |$7.50(4)| | I |By PFMI | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 11,888 | A |$7.50(5)| | I |By PFMI | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 3,685 | A |$7.50(6)| | I |By PFMI | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | Common Stock | 4/17/01 | P | | 11,573 | A |$7.50(7)| | I |By PFMI | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | | | | | | | | | | | |---------------------|-------------------|-------|------|------------|-------|--------|------------------|-------------|----------| | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. *If the form is filed by more than one reporting person, see Instruction 4(b)(v). Potential persons who are to respond to the collection of information contained in this form are not required (Over) to respond unless the form displays a currently valid OMB-control number. SEC 1474 (3/99) Page 1 of 4
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ |1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of | 6. Date Exer- |7. Title and Amount |8. Price | | Security | sion or | action | action | Derivative | cisable and | of Underlying | of | | (Instr. 3) | Exercise | Date | Code | Securities | Expiration | Securities | Deriv- | | | Price of | (Month/| (Instr.| Acquired (A) | Date | (Instr. 3 and 4) | ative | | | Deriv- | Day/ | 8) | or Disposed | (Month/Day/ | | Secur- | | | ative | Year) | | of (D) | Year) | | ity | | | Security | | | (Instr. 3, | | | (Instr. 5)| | | | | | 4, and 5) |-----------------|--------------------| | | | | | | | Date |Expira- | | Amount or| | | | | |----------|----------------| Exer- |tion | Title | Number of| | | | | | Code| V | (A) | (D) | cisable|Date | | Shares | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | |-----------------------|--------------|----------|-----|----|-------|--------|--------|--------|--------|-----------|-------------| | | | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------ | 9. Number of | 10. Ownership | 11. Nature of | | Derivative | Form of | Indirect | | Securities | Derivative | Beneficial | | Beneficially | Security: | Ownership | | Owned at End | Direct (D) | (Instr. 4) | | of Month | or Indirect (I) | | | (Instr. 4) | (Instr. 4) | | | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | |---------------------|-------------------------------|----------------------| | | | | - ------------------------------------------------------------------------------ Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal /s/ David R. Clark 05/09/01 Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). -------------------------------- ---------- **Signature of Reporting Person Date Note. File three copies of this Form, one of which must be manually signed. David R. Clark If space 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 number Page 2 Page 2 of 4
3 ATTACHMENT TO APRIL 2001 FORM 4 OF DAVID R. CLARK 361 Second Street, NW, P.O. Box 3967, Hickory, NC 28603, Relating to Pierre Foods, Inc. (Nasdaq: FOOD)
TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - -------------------- -------------------------------------------------------------------------------------------------------------- 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of (Instr. 3) action action or Disposed of (D) Securities Form: Indirect Date Code (Instr. 3, 4 and 5) Beneficially Direct Beneficial (Instr. 8) Owned at (D) or Ownership (Month/ End of Month Indirect Day/ (I) Year) (Instr. 3 and 4) (Instr. 4) (Instr. 4) - -------------------- ---------- ----- ------- --------- ------- ---------- ------------------- ------------- ---------------- Code V Amount (A) Price or (D) - -------------------- ---------- ----- ------- --------- ------- ---------- ------------------- ------------- ---------------- Common Stock 4/17/01 P 3,000 A $7.50(8) I By PFMI Common Stock 4/17/01 P 12,569 A $7.50(9) I By PFMI Common Stock 4/17/01 P 64,280 A $2.09(10) I By PFMI Common Stock 4/17/01 P 106,100 A $5.68(11) I By PFMI Common Stock 4/17/01 P 30,000 A $8.00(12) I By PFMI Common Stock 4/17/01 P 27,208 A $8.00 I By PFMI Common Stock 4/17/01 P 1,227,234 A (13) I By PFMI Common Stock 4/17/01 P 1,759,244 A (14) I By PFMI Common Stock 4/17/01 P 46,799 A (15) I By PFMI Common Stock 4/17/01 P 4,008 A (16) I By PFMI Common Stock 4/17/01 S 46,799 D (17) I By Columbia Hill Common Stock 4/17/01 S 4,008 D (18) D Common Stock 3,630,212 I By PFMI Page 3 of 4
4 ATTACHMENT TO APRIL 2001 FORM 4 OF DAVID R. CLARK 361 Second Street, NW, P.O. Box 3967, Hickory, NC 28603, Relating to Pierre Foods, Inc. (Nasdaq: FOOD) (1) Represented by a promissory note for $2,163,465 (2) PF Management, Inc. ("PFMI") is a corporation of which the Reporting Person is a director and owns 35.25% of the common stock. (3) Represented by a promissory note for $73,245 (4) Represented by a promissory note for $182,970 (5) Represented by a promissory note for $89,160 (6) Represented by a promissory note for $27,638 (7) Represented by a promissory note for $86,798 (8) Represented by a promissory note for $22,500 (9) Represented by a promissory note for $94,268 (10) Represented by a promissory note for $134,125 (11) Represented by a promissory note for $602,500 (12) Represented by a promissory note for $240,000 (13) HERTH Management, LLC contributed 1,227,234 shares of Common Stock to PFMI in exchange for 11,875 shares of PFMI stock. PFMI is a new corporation formed for the purpose of acquiring Pierre Foods, Inc. PFMI has no material assets and a substantial amount of debt. The value of its common stock is considered to be nominal. (14) James C. Richardson, Jr. contributed 1,759,244 shares of Common Stock to PFMI in exchange for 52,875 shares of PFMI stock. See note (13) for information relating to the value of PFMI stock. (15) Columbia Hill, LLC, a limited liability company of which the Reporting Person owned an approximately 53% membership interest ("Columbia Hill"), contributed 46,799 shares of Common Stock to PFMI in exchange for 59,059 shares of PFMI stock. Thereafter, Columbia Hill liquidated and distributed 31,242 shares of PFMI stock to the Reporting Person. See note (13) for information relating to the value of PFMI stock. (16) The Reporting Person contributed 4,008 shares of Common Stock (including 1,250 previously held by the Reporting Person in an individual retirement account) to PFMI in exchange for 4,008 shares of PFMI stock. See note (13) for information relating to the value of PFMI stock. (17) See note (15) for a description of this transaction. (18) See note (16) for a description of this transaction. Page 4 of 4 -----END PRIVACY-ENHANCED MESSAGE-----