-----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, QiXDMU7fGTJ4l3WuZeMYfurwySPwisRjWQr1osoFmhSZdrJD6I2GgvQ4nTyvs/+B J4NVlNLvwI/DuHAOEZJBPg== 0000950172-98-000454.txt : 19980511 0000950172-98-000454.hdr.sgml : 19980511 ACCESSION NUMBER: 0000950172-98-000454 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980504 FILED AS OF DATE: 19980508 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ULTRA PAC INC CENTRAL INDEX KEY: 0000813134 STANDARD INDUSTRIAL CLASSIFICATION: CONVERTED PAPER & PAPERBOARD PRODS (NO CONTAINERS/BOXES) [2670] IRS NUMBER: 411581031 STATE OF INCORPORATION: MN FISCAL YEAR END: 0131 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-18252 FILM NUMBER: 98614271 BUSINESS ADDRESS: STREET 1: 21925 INDUSTRIAL BLVD CITY: ROGERS STATE: MN ZIP: 55374 BUSINESS PHONE: 6124288340 MAIL ADDRESS: STREET 1: 21925 INDUSTRIAL BLVD CITY: ROGERS STATE: MN ZIP: 55374 COMPANY DATA: COMPANY CONFORMED NAME: IVEX PACKAGING CORP /DE/ CENTRAL INDEX KEY: 0000900367 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS, FOIL & COATED PAPER BAGS [2673] OWNER IRS NUMBER: 760171625 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 100 TRI STATE DR STREET 2: SUITE 200 CITY: LINCOLNSHIRE STATE: IL ZIP: 60069 BUSINESS PHONE: 7089459100 MAIL ADDRESS: STREET 1: 100 TRI STATE DRIVE STREET 2: SUITE 200 CITY: LINCOLNSHIRE STATE: IL ZIP: 60069 FORMER COMPANY: FORMER CONFORMED NAME: IVEX HOLDINGS CORP DATE OF NAME CHANGE: 19940920 3 1 FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION _____________________ WASHINGTON, D.C. 20549 | OMB APPROVAL | INITIAL STATEMENT OF |_____________________| BENEFICIAL OWNERSHIP OF SECURITIES |OMB NUMBER: 3235-0104| |EXPIRES: | | SEPTEMBER 30, 1998 | Filed pursuant to Section 16(a) of the |ESTIMATED AVERAGE | Securities Exchange Act of 1934, |BURDEN HOURS | Section 17(a) of the Public Utility |PER RESPONSE 0.5 | Holding Company Act of 1935 |_____________________| or Section 30(f) of the Investment Company Act of 1940 ___________________________________________________________________________ 1. Name and Address of Reporting Person Ivex Packaging Corporation _________________________________________________________________________ (Last) (First) (Middle) 100 Tri-State Drive _________________________________________________________________________ (Street) Lincolnshire, Illinois 60069 _________________________________________________________________________ (City) (State) (Zip) ___________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) 04/23/1998 ___________________________________________________________________________ 3. IRS OR SOCIAL SECURITY NUMBER OF REPORTING PERSON (VOLUNTARY) 76-0171625 ___________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Ultra Pac, Inc. "UPAC" ___________________________________________________________________________ _ 5. RELATIONSHIP OF REPORTING PERSON(S) TO ISSUER (CHECK ALL APPLICABLE) ( ) DIRECTOR (X ) 10% OWNER ( ) OFFICER (GIVE TITLE BELOW) ( ) OTHER (SPECIFY TITLE BELOW) _____________________________________ ___________________________________________________________________________ 6. 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 =========================================================================== TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED ___________________________________________________________________________ |1. TITLE OF SECURITY|2. AMOUNT OF |3. OWNERSHIP |4. NATURE OF INDIRECT | | (INSTR. 4) | SECURITIES | FORM DIRECT| BENEFICIAL OWNERSHIP| | | BENEFICIALLY| DIRECT (D) | (INSTR. 5) | | | OWNED | OR INDIRECT| | | | (INSTR. 4) | (I) (INSTR.| | | | | 5) | | |____________________|_______________|______________|_______________________| Common Stock, no par 3,707,000 D value per share =========================================================================== TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ___________________________________________________________________________ 1. Title of Derivative Security (Instr. 4) ___________________________________________________________________________ 2. Date Exercisable and Expiration Date (Month/Day/Year) ________________________ _________________________ Date Exercisable Expiration Date ___________________________________________________________________________ 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) ________________________________ _______________________________ Title Amount of Number of Shares ___________________________________________________________________________ 4. Conversion or Exercise Price of Derivative Security ___________________________________________________________________________ 5. Ownership Form of Derivative Security: Direct(D) or Indirect(I)(Instr. 5) ___________________________________________________________________________ 6. Nature of Indirect Beneficial Ownership (Instr. 5) =========================================================================== EXPLANATION OF RESPONSES: /s/ G. Douglas Patterson 05/08/1998 ___________________________ ____________________ Ivex Packaging Corporation DATE By: G. Douglas Patterson Title: Vice President and General Counsel _____________________________ ** 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 PROVIDED IS INSUFFICIENT, SEE INSTRUCTION 6 FOR PROCEDURE POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOR REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB NUMBER. =========================================================================== -----END PRIVACY-ENHANCED MESSAGE-----