-----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, Ufz5IcPXcMrXYwMSfGEr7rZ+e6xmC4P+ybNg6BA9ScLwd4qJjoiOUqhPgXRcMo7W PhuQqidf8veXaoVFejXNKA== 0000851968-03-000007.txt : 20030107 0000851968-03-000007.hdr.sgml : 20030107 20030107145218 ACCESSION NUMBER: 0000851968-03-000007 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030107 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MOHAWK INDUSTRIES INC CENTRAL INDEX KEY: 0000851968 STANDARD INDUSTRIAL CLASSIFICATION: CARPETS AND RUGS [2273] IRS NUMBER: 521604305 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13697 FILM NUMBER: 03506443 BUSINESS ADDRESS: STREET 1: 160 S INDUSTRIAL BLVD STREET 2: PO BOX 12069 CITY: CALHOUN STATE: GA ZIP: 30701 BUSINESS PHONE: 7066297721 MAIL ADDRESS: STREET 1: P O BOX 12069 CITY: CALHOUN STATE: GA ZIP: 30703 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: SWIFT JOHN D CENTRAL INDEX KEY: 0001201492 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: MOHAWK INDUSTRIES INC STREET 2: P O BOX 12069 CITY: CALHOUN STATE: GA ZIP: 30703 BUSINESS PHONE: 7066242239 MAIL ADDRESS: STREET 1: MOHAWK INDUSTRIES INC STREET 2: P O BOX 12069 CITY: CALHOUN STATE: GA ZIP: 30703 5 1 form5-jan.txt FORM5-SWIFT 5 1 NEW YORK 0001201492 Officer MOHAWK INDUSTRIES, INC. 40851968 52-1604305 12/31/02 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) SWIFT, JOHN D. 12015 BROOKFIELD CLUB DRIVE ROSWELL, GA 30075 2. Issuer Name and Ticker or Trading Symbol MOHAWK INDUSTRIES, INC. (MHK) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/02 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) CFO, V.P. OF FINANCE 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 Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Security 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/16/02 I 14,523 D 31,530 D Direct Common Stock 14,533 I by Managed Account Common Stock 1,500 I joint with spouse Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration - ------------------------------------------------------------------------------------------------------------------------------------ Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses:
SIGNATURE OF REPORTING PERSON /S/ SWIFT, JOHN D. DATE 01/07/03 -----END PRIVACY-ENHANCED MESSAGE-----