-----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, Su/hRQK/HD8rPaPJU9rCdyQeM1nwG20N1PluEMlUwH8ZgBMpGy9kxbMx0iU7hM5E Q24mpCH1L/xkoPPUYaFs7w== 0001017288-00-000003.txt : 20000207 0001017288-00-000003.hdr.sgml : 20000207 ACCESSION NUMBER: 0001017288-00-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000203 FILED AS OF DATE: 20000204 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: LOEWEN GROUP INC CENTRAL INDEX KEY: 0000845577 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PERSONAL SERVICES [7200] IRS NUMBER: 980121376 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-12163 FILM NUMBER: 523726 BUSINESS ADDRESS: STREET 1: 4126 NORLAND AVE CITY: BURNABY BC CANADA V5 STATE: A1 ZIP: V5G 3S8 BUSINESS PHONE: 6042999321 MAIL ADDRESS: STREET 1: 4126 NORLAND AVE STREET 2: BRITISH COLUMIA CITY: BURNABY V5G 3S8 STATE: A1 COMPANY DATA: COMPANY CONFORMED NAME: NAKAGAWA DANIEL N CENTRAL INDEX KEY: 0001027906 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: THE LOEWEN GROUP INC STREET 2: 4126 NORLAND AVENUE BURNABY BC CANADA CITY: BURNABY CANADA BUSINESS PHONE: 6092999321 MAIL ADDRESS: STREET 1: THE LOWEN GROUP INC STREET 2: 4126 NORLAND AVENUE V5G 3S8 CITY: BURNABY CANADA BC 4 1
- ---------------- U.S. SECURITIES AND EXCHANGE COMMISSION ---------------------------- |F O R M 4| Washington, D.C. 20549 | OMB APPROVAL | - ---------------- |--------------------------| STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0287| [ ] Check this box if |Expires: September 30,1998| no longer Subject Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, |Estimated ave. burden | to Section 16. Section 17(a) of the Public Utility Holding Company Act of 1935 or |hours per response.....0.5| Section 30(f) of the Investment Company Act 1940 ---------------------------- - ------------------------------------------------------------------------------------------------------------------------------------ |1.Name and Address of Reporting Person* |2.Issuer Name and Ticker or Trading Symbol |6.Relationship of Reporting Person to | | | | Issuer (Check all Applicable) | |NAKAGAWA Daniel N. |The Loewen Group Inc. | | | | of Reporting Person | Year |---(give title below) ---(Specify below)| | | | Director 10% Owner | |----------------------------------------|------------------------------------------------|--- --- | | (Last) (First) (MI)|3.IRS or Soc. Sec. No. |4.Statement for Month/ | X Officer Other | | | of Reporting Person | Year |---(give title below) ---(Specify below)| | 4126 Norland Ave | (Voluntary) | | | | | | January 2000 | President, Loewen Life Group | | | | | Inc. | |----------------------------------------| |------------------------|----------------------------------------| | (Street) | |5.If Amendment, Date of |7. Individual or Joint/Group Filing | | | | Original (Month/Year) | (Check Applicable Line) | | | | | | |Burnaby BC V5G -3S8 | | | 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 |2.Transac- |3.Trans. |4.Security Acquired (A) or |5.Amount of |6. |7.Nature of Indirect| | (Instr. 3) | tion Date | Code | Disposed of (D) | Securities |Own.| Beneficial | | |(Mon/Day/Yr)|(Instr.8)| (Instr. 3, 4 & 5) | Beneficially |Form| Ownership | | | |---------|-------------------------------| Owned at End of|(D) | (Instr. 4) | | | | | | |(A) | | Month |or | | | | |Code| V | Amount |(D) | Price | (Instr. 3 & 4) |(I) | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | |-------------------------------|------------|----|----|----------------|----|---------|-----------------|----|--------------------| | | | | | | | | | | | | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class securities owned directly or indirectly. SEC 1474 (7-96) *If the form is filed by more than one reporting person, see Instruction 4(b)(v). PAGE: 1 OF 2
FORM 4 (continued) TABLE II - Derivative Securities Acquired, Disposed of, Beneficially Owned (e.g., puts, calls, warrants, options, convertible security) - ------------------------------------------------------------------------------------------------------------------------------------ |1.Title of|2.Conver-|3. |4.Tran- |5.Number of |6.Date |7.Title and Amount |8.Price of|9.Number |10. |11.Nature | |Derivative|sion or |Trans| saction| Derivative |Exercisable| of Underlying |Derivative| of |Own.| of | |Security |Exercise |Date | Code | Securities |and | Securities |Security |Derivative|Form|Indirect | |(Instr. 3)|Price of |(Mon/|(Instr.8)| Acquired (A) or |Expiration | (Instr. 3 & 4) |(Instr. 5)|Securities|of |Beneficial| | |Deriva- | Day/| | Disposed of (D) |Date | | |Benefi- |Deri|Ownership | | |tive |Year)| | (Instr. 3, 4 & 5) |(Month/Day/| | |cially |Sec.|(Instr. 4)| | |Security | | | | Year) | | |Owned at |Dir.| | | | | | | |-----------|---------------------| |End of |(D) | | | | | | | | | | |Amount or | |Month |or | | | | | |---------|---------------------|Date |Exp. | Title |Number of | |(Instr. 4)|Ind.| | | | | |Code| V | (A) | (D) |Exbl.|Date | |Shares | | |(I) | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | |Stock Opti| $41.8000| | | | 1107| | |09/15|Common Sto| | $41.8000 | 1107| D | | |on | | | | | | | | 2007|ck | | | | | | | | | | | | | | | | | | | | | | | | (01)| | | | | | (02)| | | | (01)| | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| |Stock Opti| $35.1880| | | | 10000| | |07/18|Common Sto| | | 10000| D | | |on | | | | | | | | 2007|ck | | | | | | | | | | | | | | | | | | | | | | | | (01)| | | | | | (03)| | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| |Stock Opti| $36.8500| | | | 15000| | |08/01|Common Sto| | | 15000| D | | |on | | | | | | | | 2006|ck | | | | | | | | | | | | | | | | | | | | | | | | (01)| | | | | | (04)| | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| |Calls | $24.6471| | | | 500| | | |Common Sto| | $24.6471 | 500| D | | | | | | | | | | | |ck | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | (05)| (05)| | | (01)| | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| |TLGI Fund | $.6100| | | | 6176.0278| | | |Common Sto| | | 6176.0278| I |TLGI Fund | | | | | | | | | | |ck | | | | | | | | | | | | | | | | | | | | | | | | (01)| | | | | | (06)| (06)| | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |----------|---------|-----|----|----|----------|----------|-----|-----|----------|----------|----------|----------|----|----------| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (01) Canadian Funds (02) An option to acquire 1,107 shares immediately. (03) An option to acquire 10,000 shares, exercisable in five equal annual increments beginning July 18, 1998. (04) An option to acquire 15,000 shares, exercisable in five equal annual increments beginning August 1, 1997. (05) Withdrew entitlement to purchase 500 common shares pursuant to employee Share Purchase Plan. (06) Under The Loewen Group Inc. Group Retirement Saving Plan, the reporting person invests in the Trust Fund. The Trust Fund invests primarily in common shares but also maintains cash reserves. The Trust Fund operates as a pooled fund. No com mon shares are allocated to individual participants' accounts and distributions are made entirely in cash. Based on the reporting person's investment in the Trust Fund and the common shares price at 11/30/99. **Intentional misstatements or omissions of facts constitute Federal /s/Bradley D. Stam 02/03/2000 Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------------------ ---------- **Signature of Reporting Person Date Note: File three copies of this form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. SEC 1474 (7-96) 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 OMD Number NAKAGAWA, Daniel N. The Loewen Group Inc. JAN-2000 PAGE: 2 OF 2
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