0001140361-12-001513.txt : 20120106
0001140361-12-001513.hdr.sgml : 20120106
20120106151354
ACCESSION NUMBER: 0001140361-12-001513
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120102
FILED AS OF DATE: 20120106
DATE AS OF CHANGE: 20120106
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: WELLS JOHN R
CENTRAL INDEX KEY: 0001095555
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33994
FILM NUMBER: 12514326
MAIL ADDRESS:
STREET 1: 2859 PACES FERRY ROAD
STREET 2: SUITE 2000
CITY: ATLANTA
STATE: GA
ZIP: 30339
ISSUER:
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: 0317
BUSINESS ADDRESS:
STREET 1: 2859 PACES FERRY RD
STREET 2: STE 2000
CITY: ATLANTA
STATE: GA
ZIP: 30339
BUSINESS PHONE: 7704376800
MAIL ADDRESS:
STREET 1: 2859 PACES FERRY RD
STREET 2: STE 2000
CITY: ATLANTA
STATE: 2Q
ZIP: 30339
FORMER COMPANY:
FORMER CONFORMED NAME: INTERFACE FLOORING SYSTEMS INC
DATE OF NAME CHANGE: 19870817
4
1
doc1.xml
FORM 4
X0304
4
2012-01-02
0
0000715787
INTERFACE INC
IFSIA
0001095555
WELLS JOHN R
2859 PACES FERRY ROAD
OVERLOOK III, SUITE 2000
ATLANTA
GA
30339
0
1
0
0
Sr. Vice President
Class B Common Stock
2012-01-02
4
D
0
16333
0
D
154514
D
Class B Common Stock
2012-01-02
4
F
0
5700
11.54
D
148814
D
Class B Common Stock
2012-01-04
4
C
0
10633
0
D
138181
D
Class A Common Stock
2012-01-04
4
C
0
10633
0
A
256208
D
Conversion of a security exempted pursuant to Rule 16(b)-6b. The reporting person exchanged Class B shares for Class A shares on a one-for-one basis.
A substantial number of such shares are restricted shares subject to a risk of forfeiture under certain circumstances.
/s/ David B. Foshee, Attorney in Fact
2012-01-06