-----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, L+H0Mkf8+MYIfzNGOEWy3ySDoM3IA1C+exqe1qhxB9gZCLgSKP5hB2jtgjHjgk8i xutX9q1sFlAM1hgn30nc0Q== 0000910195-99-000377.txt : 19990709 0000910195-99-000377.hdr.sgml : 19990709 ACCESSION NUMBER: 0000910195-99-000377 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990623 FILED AS OF DATE: 19990708 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INTERFACE INC CENTRAL INDEX KEY: 0000715787 STANDARD INDUSTRIAL CLASSIFICATION: CARPETS AND RUGS [2273] IRS NUMBER: 581451243 STATE OF INCORPORATION: GA FISCAL YEAR END: 0103 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-12016 FILM NUMBER: 99660775 BUSINESS ADDRESS: STREET 1: 2859 PACES FERRY RD STREET 2: STE 2000 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: 7704376800 FORMER COMPANY: FORMER CONFORMED NAME: INTERFACE FLOORING SYSTEMS INC DATE OF NAME CHANGE: 19870817 COMPANY DATA: COMPANY CONFORMED NAME: ANDERSON RAY C CENTRAL INDEX KEY: 0000937733 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] OFFICER STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 2859 PACES FERRY ROAD STREET 2: SUITE 2000 CITY: ATLANTA STATE: GA ZIP: 30339 MAIL ADDRESS: STREET 1: C/O KILPATRICK & CODY STREET 2: 1100 PEACHTREE ST CITY: ATLANTA STATE: GA ZIP: 30309-4530 4 1 FORM 4 FORM 4 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 _______________________________________________________________________________ 1. Name and Address of Reporting Person Anderson Ray C. - ----------------------------------------------------- (Last) (First) (Middle) 2859 Paces Ferry Road - ----------------------------------------------------- (Street) Atlanta Georgia 30339 - ----------------------------------------------------- (City) (State) (Zip) _______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Interface, Inc. (IFSIA) _______________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person (Voluntary) --------------- _______________________________________________________________________________ 4. Statement for Month/Year June 1999 _______________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) _______________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [x] 10% Owner [x] Director [x] Officer (give title below) [ ] Other (specify below) Chairman and CEO --------------------------------------------------------- Page 1 FORM 4 (continued)
TABLE I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. - --------------------- -------- ---------- ------------------------------ ----------- ---------- ---------- Amount of Owner- Securities ship Trans- Trans- Securities Acquired (A) Beneficially Form: action action or Disposed of (D) Owned at Direct Nature of Date Code (Instr. 3, 4 and 5) End of (D) or Indirect Title of (Month/ (Instr. 8) ---------------------------- Month Indirect Beneficial Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership (Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4) - --------------------- -------- ---- ---- ----------- ------ --------- ----------- ---------- ---------- Class A Common Stock 06-23-99 P 200 (A) $7.1875 4,200 I Spouse
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) Page 2 FORM 4 (continued)
TABLE II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g. puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. - ---------- -------- -------- -------- ---------- ------------ -------------- ------ ---------- --------- ---------- Title and Ownership Number of Date Exer- Amount of Form of Derivative cisable and Underlying Number of Deriv- Securities Expiration Securities Price Derivative ative Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security: sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership (Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4) - ---------- -------- -------- ---- --- ---- ---- ------- ----- ----- ------ ------ ---------- -------- ----------
Explanation of Responses: [FN] The reporting person disclaims beneficial ownership of the shares held by his spouse. /s/ Ray C. Anderson July 8, 1999 ---------------------------------------- -------------------- Ray C. Anderson ** 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). Page 3 -----END PRIVACY-ENHANCED MESSAGE-----