-----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, U3J5vnzkCs2ch0vtsFuQVbXGjH7DODhfoulEG4UZJn+BVXi8CnrEFMxxqUyi09N1 7hzRMqk/FIHP840SuTPXQw== 0001167966-04-001003.txt : 20041103 0001167966-04-001003.hdr.sgml : 20041103 20041103173115 ACCESSION NUMBER: 0001167966-04-001003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041101 FILED AS OF DATE: 20041103 DATE AS OF CHANGE: 20041103 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: HENDRIX DANIEL T CENTRAL INDEX KEY: 0001094629 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-12016 FILM NUMBER: 041117330 BUSINESS ADDRESS: STREET 1: 2859 PACES PERRY ROAD CITY: ATLANTA STATE: GA ZIP: 30339 MAIL ADDRESS: STREET 1: 2859 PACES ROAD 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: 0103 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 4 1 edgar.xml PRIMARY DOCUMENT X0202 4 2004-11-01 0000715787 INTERFACE INC IFSIA 0001094629 HENDRIX DANIEL T 2859 PACES FERRY ROAD, SUITE 2000 ATLANTA GA 30339 1 1 0 0 President and CEO Class B Common Stock 2004-11-01 4 C 0 2000 D 423673 D Class A Common Stock 2004-11-01 4 C 0 2000 A 49260 D Class A Common Stock 2004-11-01 4 S 0 43 8.51 D 49217 D Class A Common Stock 2004-11-01 4 S 0 14 8.52 D 49203 D Class A Common Stock 2004-11-01 4 S 0 200 8.54 D 49003 D Class A Common Stock 2004-11-01 4 S 0 100 8.55 D 48903 D Class A Common Stock 2004-11-01 4 S 0 800 8.56 D 48103 D Class A Common Stock 2004-11-01 4 S 0 300 8.57 D 47803 D Class A Common Stock 2004-11-01 4 S 0 543 8.58 D 47260 D Class B Common Stock 4146.2369 I By 401(k) plan Conversion of a security exempted pursuant to Rule 16b-6(b). 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. This sale was effected pursuant to a Rule 10b5-1(c) trading plan adopted by the reporting person on June 30, 2004. Daniel T. Hendrix 2004-11-03 -----END PRIVACY-ENHANCED MESSAGE-----