-----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, H75i7bhghHfY5MnBrAmP6I7KNuQtgZ7+kvJa28KEW2vUQZKuHe5SrMu6qFT7ZmeK 1ibw5Db5RFBqMHyOF8jI/g== 0001212243-03-000002.txt : 20030103 0001212243-03-000002.hdr.sgml : 20030103 20030103145510 ACCESSION NUMBER: 0001212243-03-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030103 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: LOR INC CENTRAL INDEX KEY: 0001212243 RELATIONSHIP: OWNER IRS NUMBER: 581317627 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 2170 PIEDMONT RD. N.E. CITY: ATLANTA STATE: GA ZIP: 30324 BUSINESS PHONE: 4048882753 MAIL ADDRESS: STREET 1: 2170 PIEDMONT RD. N.E. CITY: ATLANTA STATE: GA ZIP: 30324 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ROLLINS INC CENTRAL INDEX KEY: 0000084839 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340] IRS NUMBER: 510068479 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-04422 FILM NUMBER: 03502785 BUSINESS ADDRESS: STREET 1: 2170 PIEDMONT RD NE CITY: ATLANTA STATE: GA ZIP: 30324 BUSINESS PHONE: 4048882000 MAIL ADDRESS: STREET 1: 2170 PIEDMONT ROAD NE CITY: ATLANTA STATE: GA ZIP: 30324 4 1 lorform4.txt FORM 4 FOR LOR. INC. 12/31/02 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 OMB APPROVAL ---------------------------- OMB Number: 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response.......0.5 FORM 4 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 [ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* LOR, Inc. . - -------------------------------------------------------------------------------- (Last) (First) (Middle) 2170 Piedmont Road NE - -------------------------------------------------------------------------------- (Street) Atlanta, GA 30324 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Rollins, Inc. (ROL) - -------------------------------------------------------------------------------- 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 58-1317627 - -------------------------------------------------------------------------------- 4. Statement for Month/Day/Year 12/31/02 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Day/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [X] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) Executive VP Orkin Exterminating Company - -------------------------------------------------------------------------------- 7. Individual or Joint/Group Filing (Check Applicable Line) [ ] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person - -------------------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
5. Amount of 6. 2A. 4. Securities Owner- Deemed Securities Acquired (A) or Beneficially ship 2. Execution 3. Disposed of (D) Owned Form: 7. Transaction Date, Transaction (Instr. 3, 4 and 5) Following Direct Nature of Date if any Code ---------------------------- Reported (D) or Indirect 1. (Month/ (Month/ (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Day/ Day/ ----------- Amount or Price (Instr. 3 (I) Ownership (Instr. 3) Year) Year) Code V (D) and 4) (Instr. 4) (Instr. 4) - ----------------------------------------------------------------------------------------------------------------------------------- Rollins, Inc. 12/31/02 J(a) 10,419,000 D 0 D Common Stock $1 Par Value - ----------------------------------------------------------------------------------------------------------------------------------- Rollins, Inc. 12/31/02 J(a) 1,359,000 D 0 I By Limited Common Stock $1 Liability Co. Par Value - ----------------------------------------------------------------------------------------------------------------------------------- Rollins, Inc. 12/31/02 J(a) 14,079,185 A 14,079,185 I RFPS Common Stock $1 Investment Par Value I, L.P. - ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================
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). J(a) - See Attached Exhibit A (Over) SEC 1474 (9/02) FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. Number 10. of Owner- Deriv- ship 2. ative Form Conver- 5. 7. Secur- of 11. sion Number of Title and Amount ities Deriv- Nature or 3A. Derivative 6. of Underlying 8. Bene- ative of Exer- Deemed 4. Securities Date Securities Price ficially Secur- In- cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) or Owned ity: direct Price Trans- tion action or Disposed Expiration Date ---------------- Deriv- Following Direct Bene- 1. of action Date, Code of (D) (Month/Day/Year) Amount ative Reported (D) or ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- Trans- Indirect Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity action(s) (I) ship Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr, 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ Glenn P. Grove, Jr. LOR Inc. - Assistant Secretary January 3, 2002 - ---------------------------------- ----------------------- **Signature of Reporting Person 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 provided is insufficient, see Instruction 6 for procedure. 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 Exhibit A LOR, Inc. (a) On December 31, 2002, all Rollins, Inc. ("ROL") shares held directly by Reporting Person and ROL shares held indirectly by Reporting Person through RCTLOR, LLC, a Georgia limited liability company for which Reporting Person acts as Manager, were contributed to RFPS Investments I, L.P. ("RFPS"), a Georgia limited partnership, of which LOR Investment Company, LLC, a wholly owned Georgia limited liability company of the Reporting Person is the General Partner. The Reporting Person has elected to report all of the shares held by RFPS, but disclaims beneficial ownership of the shares in excess of its pecuniary interest. -----END PRIVACY-ENHANCED MESSAGE-----