3 1 overhillcorp2002-form3.txt
FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL Washington, D.C. 20549 OMB Number 3235-0104 Expires: December 31, 2005 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Estimated average burden hours per response....0.5 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 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol 6. If Amendment, of Reporting Person Requiring Statement Date of Original (Month/Day/Year) (Month/Day/Year) Overhill Corporation 10/08/02 OVERHILL FARMS, INC. OFI(1) ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. I.R.S. 5. Relationship of Reporting Person(s) 7. Individual or Joint / Identification to Issuer Group Filing (Check Number of (Check all applicable) applicable line) 4800 BROADWAY, SUITE A Reporting Person -------------------------------- (voluntary) Director X 10% Owner X Form filed by One (Street --- --- --- Reporting Person ADDISON TX 75001 -------------------- Officer Other -------------------------------- --- (give title --- (specify Form filed by More (City) (State) (Zip) below) below) --- than One Reporting Person ---------------------------- Table I-- Non-Derivative Securities Beneficially Owned ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial (Instr. 4) Beneficially Owned Direct (D) Ownership (Instr. 5) (Instr. 4) or Indirect (I) (Instr. 5) COMMON STOCK 9,307,7500(2) D(2) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ 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 5 (b)(v). Page 1 FORM 3 (continued) Table II-- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Date Exer- 3. Title and Amount of 4. Conver- 5. Ownership 6. Nature of Derivative cisable and Securities Underlying sion or Form of Indirect Security Expiration Derivative Security Exercise of Derivative Beneficial (Instr. 4) Date (Instr. 4) Derivative Security: Ownership (Month/Day/ Security Direct (D) or (Instr. 5) Year) Indirect (I) (Instr. 5) ---------------------------------------------------------------------------------------------------------------- Date Expiration Title Amount or Exercisable Date Number of Shares ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Proposed ticker symbol reserved with the American Stock Exchange. (2) Shares of common stock of Overhill Farms, Inc. expected to be distributed by the reporting person in the spin-off transaction described in the Registration Statement on Form 10 of the issuer. In the spin-off, the reporting person will distribute to its stockholders one share of common stock of the issuer for every two shares of common stock of Overhill Corporation that the stockholders owned on September 30, 2002. The reporting person has not yet distributed the shares of common stock of the issuer as of the date of this Form 3. ** Intentional misstatements of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). OVERHILL CORPORATION By: /s/ William E. Shatley 10/23/02 ----------------------------- -------------- Note: File three copies of this Form, one of which must be manually signed. **Signature of reporting person Date If space provided is insufficient, see Instruction 6 for procedure. Senior Vice President 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