-----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, E1qk0ylbbQlbBCykPqRXK9jmIBMr8XgC3d1aBxFnLPmiioDSF3s9XqVee3pwvOdp RD4v4LvCdjQf4U2Y1R+BNg== 0000075362-02-000038.txt : 20021209 0000075362-02-000038.hdr.sgml : 20021209 20021206174212 ACCESSION NUMBER: 0000075362-02-000038 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021205 FILED AS OF DATE: 20021209 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: TEMBREULL MICHAEL A CENTRAL INDEX KEY: 0001191932 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: PACCAR INC STREET 2: P.O. BOX 1518 CITY: BELLEVUE STATE: WA ZIP: 98009 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PACCAR INC CENTRAL INDEX KEY: 0000075362 STANDARD INDUSTRIAL CLASSIFICATION: MOTOR VEHICLES & PASSENGER CAR BODIES [3711] IRS NUMBER: 910351110 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14817 FILM NUMBER: 02851525 BUSINESS ADDRESS: STREET 1: 777 106TH AVE NE STREET 2: PO BOX 1518 CITY: BELLEVUE STATE: WA ZIP: 98004 BUSINESS PHONE: 4254557383 MAIL ADDRESS: STREET 1: 777 106TH AVENUE NE STREET 2: PO BOX 1518 CITY: BELLEVUE STATE: WA ZIP: 98004 FORMER COMPANY: FORMER CONFORMED NAME: PACIFIC CAR & FOUNDRY CO DATE OF NAME CHANGE: 19720707 4 1 edgar.htm 4 Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

OMB APPROVAL

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

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 Number: 3235-0287
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Filed By Romeo & Dye's Instant Form 4 Filer
www.section16.net



1. Name and Address of Reporting Person*

TEMBREULL MICHAEL A

2. Issuer Name and Ticker or Trading Symbol
PACCAR Inc (PCAR)

6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
X Director                                       10% Owner
X Officer (give title below)          Other (specify below)

VICE CHAIRMAN                                     

(Last)      (First)     (Middle)

777 106TH AVENUE NE
 

3. I.R.S. Identification Number
of Reporting Person,
if an entity (voluntary)

 

4. Statement for
Month/Day/Year
12/5/2002

(Street)

BELLEVUE, WA 98004

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. Trans-
action
Date
(Month/ Day/
Year)

2A. Deemed
Execution
Date,
if any
(Month/Day/
Year)

3. Trans-
action Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 & 5)

5. Amount of
Securities
Beneficially
Owned Follow-
ing Reported Transactions(s)
(Instr. 3 & 4)

6. Owner-
ship Form:
Direct (D)
or Indirect (I)
(Instr. 4)

7. Nature of Indirect
Beneficial Ownership
(Instr. 4)

Code

V

Amount

(A)
or
(D)

Price

COMMON STOCK

 

 

 

 

 

 

 

14,016

D

 

COMMON STOCK (SIP)(1)

 

 

 

 

 

20,524.2(2)

D

 

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).

Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number

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. Conver-
sion or
Exercise
Price of Derivative Security

3. Trans-
action Date

(Month/
Day/
Year)

3A. Deemed
Execution
Date,
if any
(Month/
Day/
Year)

4. Trans-
action
Code

(Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D)

(Instr. 3, 4 & 5)

6. Date Exercisable
and Expiration
Date
(Month/Day/
Year)

7. Title and Amount of Underlying Securities
(Instr. 3 & 4)

8. Price of Derivative Security
(Instr. 5)

9. Number of
Derivative
Securities
Beneficially
Owned
Following
Reported Transaction(s)
(Instr. 4)

10. Owner-
ship Form
of Deriv-
ative
Security:
Direct (D)
or Indirect (I)
(Instr. 4)

11. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

(A)

(D)

Date Exer-cisable

Expira-
tion
Date

Title

Amount or Number of
Shares

STOCK OPTION

$35.67

 

 

 

 

 

 

01/01/01

04/28/08

COMMON STOCK

37,876

 

37,876

D

 

STOCK OPTION

$35.85

 

 

 

 

 

 

01/01/02

04/27/09

COMMON STOCK

52,519

 

52,519

D

 

STOCK OPTION

$27.83

 

 

 

 

 

 

01/01/03

01/25/10

COMMON STOCK

63,915

 

63,915

D

 

STOCK OPTION

$34.42

 

 

 

 

 

 

01/01/04

01/24/11

COMMON STOCK

57,633

 

57,633

D

 

STOCK OPTION

$42.31

 

 

 

 

 

 

01/01/05

01/23/12

COMMON STOCK

47,934

 

47,934

D

 

COMMON STOCK (LTIP)

N/A

12/05/02

 

J(3)

 

73.1(2)

 

N/A

N/A

COMMON STOCK

73.1(2)

$47.29

17,361.5(2)

D

 

COMMON STOCK (DICP)

N/A

12/05/02

 

J(4)

 

45.3(2)

 

N/A

N/A

COMMON STOCK

45.3(2)

$47.29

10,761.9(2)

D

 

Explanation of Responses:

(1) Shares held in PACCAR Savings Investment Plan (SIP)).
(2) All fractional shares rounded to nearest 1/10.
(3) Dividend on share units held in deferred phantom stock account under PACCAR Long Term Incentive Plan (LTIP) reinvested pursuant to LTIP.
(4) Dividend on share units held in deferred phantom stock account under PACCAR Deferred Incentive Compensation Plan (DICP) reinvested pursuant to DICP.

  By: /s/ M. A. Tembreull
              
**Signature of Reporting Person
12/6/02
Date

**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.

Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.

 

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