-----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, LJ0ny2OTj/lJZYRx5VUSMgm1EEIA/kYJuy5kdKkXI6NHt19GeEDNwvVb3tNyZybl xi/tQEWCzphBnuB7F7df4A== 0001017062-97-000246.txt : 19970222 0001017062-97-000246.hdr.sgml : 19970222 ACCESSION NUMBER: 0001017062-97-000246 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970214 SROS: NASD SROS: NYSE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: US FACILITIES CORP CENTRAL INDEX KEY: 0000798085 STANDARD INDUSTRIAL CLASSIFICATION: SURETY INSURANCE [6351] IRS NUMBER: 330097221 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-37241 FILM NUMBER: 97535033 BUSINESS ADDRESS: STREET 1: 650 TOWN CENTER DR STE 1600 CITY: COSTA MESA STATE: CA ZIP: 92626 BUSINESS PHONE: 7145491600 MAIL ADDRESS: STREET 1: 650 TOWN CENTER DRIVE STREET 2: STE 1600 CITY: COSTA MESA STATE: CA ZIP: 92626-1925 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: MEDGYESY L STEVEN CENTRAL INDEX KEY: 0000903757 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 6200 NORTH HIAWATHA STREET 2: STE 400 CITY: CHICAGO STATE: IL ZIP: 60646 BUSINESS PHONE: 3125453285 MAIL ADDRESS: STREET 1: 6200 NORTH HIAWATHA AVE STREET 2: STE 400 CITY: CHICAGO STATE: IL ZIP: 60645 SC 13G 1 SC 13G - L. STEVEN MEDGYESY --------------------------- OMB APPROVAL --------------------------- OMB number: 3235-0145 Expires: October 31, 1994 Estimated average burden hours per response... 14.90 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 10 )* ----- US Facilities Corporation ------------------------------------------------------------- (Name of Issuer) Common Stock --------------------------------------------------- (Title of Class of Securities) 911822104 ----------------------------------------- (CUSIP Number) Check the following box if a fee is being paid with this statement [_]. (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7). *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). Page 1 of 4 Pages - ----------------------- --------------------- CUSIP NO. 911822104 13G PAGE 2 OF 4 PAGES - ----------------------- --------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON L. Steven Medgyesy SSN: ###-##-#### - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [_] Not Applicable - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 251,611 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 0 OWNED BY ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING 251,611 PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 67,030 - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 326,701 - ------------------------------------------------------------------------------ CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 Not Applicable - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 11 5.5% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON* 12 Individual - ------------------------------------------------------------------------------ *SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 4 pages UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 10) Item 4. Ownership: --------- (a) Amount Beneficially Owned: 326,701 /1,2/ ------------------------- (b) Percent of Class: 5.5% ---------------- (c) Number of shares as to which such person has: -------------------------------------------- (i) sole power to vote or to direct the vote: 247,611 (ii) shared power to vote or to direct the vote: 0 (iii) sole power to dispose or to direct the disposition of: 251,611 (iv) shared power to dispose or to direct the disposition of: 67,030 - -------------------- /1/ Includes 86,311 shares held by Dr. Medgyesy in his capacity as trustee of the Singer Family Trust, which trust is for the benefit of a third party and members of his family, 8,060 shares held by Dr. Medgyesy's wife, and 67,030 shares held in trusts for the benefit of Dr. Medgyesy and members of his family. Dr. Medgyesy disclaims beneficial ownership of all these shares. This amount also includes 6,500 shares which Dr. Medgyesy has the immediate right to acquire under the US Facilities Corporation 1991 Directors Stock Option Plan, Amended and Restated as of December 18, 1991. /2/ Attached to each share of Common Stock is a stock purchase right issued pursuant to the US Facilities Corporation Rights Plan. Page 3 of 4 Pages Signature - --------- After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 12, 1997 - ----------------- Date /s/ L. STEVEN MEDGYESY - ---------------------- Signature L. Steven Medgyesy - ------------------ Name/Title Page 4 of 4 Pages -----END PRIVACY-ENHANCED MESSAGE-----