-----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, P0b82PJ3gMeSv2CteMUPRJ7tfgFDYYLoKCr9aAaKg6hy0llEOW48aOyZREy/AbNB TCrPhCAeEy7C0N4xOJUAjg== 0001107049-01-500081.txt : 20010207 0001107049-01-500081.hdr.sgml : 20010207 ACCESSION NUMBER: 0001107049-01-500081 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001204 FILED AS OF DATE: 20010206 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: 1525817 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: BERTOLUCCI MICHAEL D CENTRAL INDEX KEY: 0001095549 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 2859 PACES FERRY ROAD STREET 2: SUITE 2000 CITY: ATLANTA STATE: GA ZIP: 30339 BUSINESS PHONE: 7704376800 MAIL ADDRESS: STREET 1: 2859 PACES FERRY ROAD STREET 2: SUITE 2000 CITY: ATLANTA STATE: GA ZIP: 30339 4 1 bertodec4.htm MICHAEL D. BERTOLUCCI FORM 4 FOR 12/2000 Prepared by Kilpatrick Stockton LLP EDGAR Services

Form 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 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

OMB APPROVAL

OMB Number: 3235-0287

Expires: December 31, 2001

[   ]

Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b).

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hours per response. . . 0.5


1. Name and Address of Reporting Person*

       Bertolucci                  Michael                 D.

2. Issuer Name and Ticker or Trading Symbol

Interface, Inc. (IFSIA)

6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
___ Director                    ___ 10% Owner
_X_ Officer (give             ___ Other (specify
                  title below)                     below)

Senior Vice President                   

(Last)             (First)            (Middle)


          
2859 Paces Ferry Road, Suite 2000

3. I.R.S. Identification Number of Reporting Person, if an entity voluntary)

4. Statement for Month/Year
December, 2000

(Street)


Atlanta             GA               30339

5. If Amendment, Date of Original (Month/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

(City)             (State)             (Zip)

Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 3)

2. Transaction Date
(Month/Day/Year)

3. Transaction
Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)

5. Amount of Securities Beneficially Owned at End of Month
(Instr. 3 and 4)

6. Owner-
ship Form:
Direct (D) or Indirect (I)
(Instr. 4)

7. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

Amount

(A) or (D)

Price

Class B Common Stock

12/04/00

M

 

32,000

A

$6.00

 

 

 

Class B Common Stock

12/04/00

F

 

6,843

D

$9.50

25,157

D

 

 

 

 

 

 

 

 

 

 

 

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 Instructions 4(b)(v).

 

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.

(Over)
SEC 1474 (3-99)

 


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 Security
(Instr.3)

2. Conversion or
Exercise
Price of
Derivative
Security

3. Transaction
Date
(Month/
Day/
Year)

4. Transaction Code
(Instr. 8)

5. Number of Derivative
Securities
Acquired (A) or Disposed of(D)
(Instr. 3, 4 and 5)

6. Date Exercisable
and Expiration Date
(Month/Day/Year)

7. Title and Amount of
Underlying Securities
(Instr. 3 and 4)

8. Price of
Derivative
Security
(Instr. 5)

9.Number of
Derivative
Securities
Beneficially
Owned at
End of
Month
(Instr. 4)

10. Ownership
Form of
Derivative
Security:
Direct (D) or Indirect (I)
(Instr. 4)

11. Nature of
Indirect
Beneficial
Ownership
(Instr. 4)

Code

V

(A)

(D)

Date
Exercisable

Expiration
Date

Title

Amount
or
Number
of Shares

Employee Stock Option
(right to buy)

$6.00

12/04/00

M

 

 

32,000

*

04/01/06

Class A
or B
Common Stock

32,000

 

8,000

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

  *  The option vests and becomes exercisable at the rate of 20% per year. The first, second, third and fourth increments of 8,000 shares each became exercisable on 4/1/97, 4/1/98, 4/1/99 and 4/1/00, respectively.
   



**

Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).

  /s/ Michael D. Bertolucci                                            
Michael D. Bertolucci
**Signature of Reporting Person

    2/05/01              
Date

Note:

File three copies of this Form, one of which must be manually signed.
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

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