-----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, EKExwHo5JUQdkOWqPGXZ32rqEZZHQSOWn/LxbILfwLy7gn+uRtxaWGnnhO1791ge 08x/fE9zl2kVBlSXsx6j9g== 0001107049-03-000038.txt : 20030204 0001107049-03-000038.hdr.sgml : 20030204 20030204141052 ACCESSION NUMBER: 0001107049-03-000038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030131 FILED AS OF DATE: 20030204 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: 1934 Act SEC FILE NUMBER: 000-12016 FILM NUMBER: 03538168 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 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: WILLOCH RAYMOND S CENTRAL INDEX KEY: 0001095548 RELATIONSHIP: 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 willoch0131frm4.htm FORM 4 Form 4

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(h) of the Investment Company Act of 1940

OMB APPROVAL

OMB Number: 3235-0287

Expires: January 31, 2005

[   ]

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

Estimated average burden
hours per response. . . 0.5

1.  Name and Address of Reporting Person*

 Willoch, Raymond S.

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 - Administration,
General Counsel and Secretary

(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/Day/Year

January 31, 2003

 (Street)

 

Atlanta, GA  30339

5. 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

(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)
2A. Deemed
       Execution Date, if
       any
       (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
    Following Reported
    Transactions(s)
    (Instr. 3 and 4)
6. Ownership
    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

 
1/31/03



A


 


20,000


A

 


145,542(1)        


D


 


Class B Common Stock
 






779.302    


 I

By 401(k)
Plan 


 









 








 


 

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)
3A. Deemed
       Execution
       Date,
       if any
     (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
    Following
    Reported
    Transaction(s)
    (Instr. 4)
10. Ownership
      Form of
      Derivative
      Securities
      Beneficially
      Owned at
      End of
      Month
      (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
$2.71 1/31/03   A   20,000   1/31/03(2) 1/31/06 Class A
or
Class B
Common
Stock
20,000 0 20,000 D  
















































Explanation of Responses:

(1)  A substantial number of such shares are restricted shares subject to a risk of forfeiture under certain circumstances.

(2)  50% of the option is exercisable as of the grant date, and the remaining 50% of the option vests and becomes exercisable on the first anniversary of the grant date.

    /s/ Raymond S. Willoch


Raymond S. Willoch

**Signature of Reporting Person

 2/04/03


Date

 

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).
** 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 is insufficient, see Instruction 6 for procedure
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