-----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, P/0aVmHmrWvUsGy10H40p6NhUp0tAQSLQKrkKlmAJQY04IQG/sLJJbf/vrJywCzR 7z0ks87XJcP5y++8vrE/hw== 0000932366-96-000004.txt : 19961211 0000932366-96-000004.hdr.sgml : 19961211 ACCESSION NUMBER: 0000932366-96-000004 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19961210 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: APPLEBEES INTERNATIONAL INC CENTRAL INDEX KEY: 0000853665 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 431461763 STATE OF INCORPORATION: DE FISCAL YEAR END: 1225 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-17962 FILM NUMBER: 96678130 BUSINESS ADDRESS: STREET 1: 4551 W 107TH ST STE 100 CITY: OVERLAND PARK STATE: KS ZIP: 66207 BUSINESS PHONE: 9139674000 MAIL ADDRESS: STREET 1: 4551 W 107TH STREET STREET 2: SUITE 100 CITY: OVERLAND PARK STATE: KS ZIP: 66207 COMPANY DATA: COMPANY CONFORMED NAME: SACK BURTON M CENTRAL INDEX KEY: 0000932366 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 4551 WEST 107TH ST STREET 2: STE 100 CITY: OVERLAND PARK STATE: KS ZIP: 66207 BUSINESS PHONE: 9139674000 MAIL ADDRESS: STREET 1: 4551 WEST 107TH ST STREET 2: STE 100 CITY: OVERLAND PARK STATE: KS ZIP: 66207 4 1 FORM 4 - BURTON M. SACK ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0287 Expires: April 30, 1997 Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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(f) of the Investment Company Act of 1940 [ ] Check this box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ================================================================================ 1. Name and Address of Reporting Person SACK BURTON M. - -------------------------------------------------------------------------------- (Last) (First) (Middle) Applebee's International, Inc. 4551 W. 107th Street, Suite 100 - -------------------------------------------------------------------------------- (Street) Overland Park KS 66207 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Applebee's International, Inc. - APPB ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### ================================================================================ 4. Statement for Month/Year 11/96 ================================================================================ 5. If Amendment, Date of Original (Month/Year) N/A ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ X ] Director [ ] 10% Owner [ X ] Officer (give title below) [ ] Other (specify below) Executive Vice President -------------------------------------------------------------------- ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 11/27/96 G 100 D $11.50 1,499,050 (1) D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 356,000 I (2) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 90,000 I (3) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 93,350 I (4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 99,500 I (5) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 2,040 I (6) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1,499 I (7) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== (1) Includes 7,800 shares in an IRA maintained by the reporting person. (2) Shares held by Sack Family Partners, L.P. for which reporting person is general partner. (3) Shares held by Brian M. Sack Irrevocable Trust for which reporting person is trustee. (4) Shares held by David A. Sack Irrevocable Trust for which reporting person is trustee. (5) Shares held by Scott A. Sack Irrevocable Trust for which reporting person is trustee. (6) Shares held by IRA maintained by Gail Sack, wife of the reporting person. (7) Shares held by Jill Sarmanian, step-daughter of the reporting person.
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) T V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common 31 Common Stock Stock Million 69,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ Burton M. Sack December 10, 1996 - --------------------------------------------- ----------------------- **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 procedures. -----END PRIVACY-ENHANCED MESSAGE-----