0001140361-12-008799.txt : 20120215
0001140361-12-008799.hdr.sgml : 20120215
20120215182302
ACCESSION NUMBER: 0001140361-12-008799
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110504
FILED AS OF DATE: 20120215
DATE AS OF CHANGE: 20120215
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Paisner Harold M
CENTRAL INDEX KEY: 0001390810
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-33994
FILM NUMBER: 12617151
MAIL ADDRESS:
STREET 1: BERWIN LEIGHTON PAISNER, ADELAIDE HOUSE
STREET 2: LONDON BRIDGE
CITY: LONDON
STATE: X0
ZIP: EC4R 9HA
FORMER NAME:
FORMER CONFORMED NAME: Paisner Harold
DATE OF NAME CHANGE: 20070222
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
5
1
doc1.xml
FORM 5
X0304
5
2011-05-04
0
0
1
0000715787
INTERFACE INC
IFSIA
0001390810
Paisner Harold M
2859 PACES FERRY ROAD
SUITE 2000
ATLANTA
GA
30339
1
0
0
0
Class A Common Stock
2011-05-04
4
M
0
L
5000
4.31
A
17000
D
Stock Option (Right to Buy)
4.31
2011-05-04
4
M
0
L
5000
0
D
2010-01-12
2019-01-12
Class A or Class B Common Stock
5000
0
D
Exercise of a derivative security exempted pursuant to Rule 16b-6(b).
50% of the option vested and became exercisable on the first anniversary of the grant date, and the remaining 50% of the option vested and became exercisable on January 12, 2011.
/s/ David B. Foshee, Attorney in Fact
2012-02-13