-----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, WjKebdE3YSZIbvTNWnvmXbvlLTPoWIXiNOPT9dTnlIB9EyNuysz4d+z6qNppnrGe HLZH4E+mXTC5ab9O6M0cMA== 0000854560-01-500035.txt : 20020410 0000854560-01-500035.hdr.sgml : 20020410 ACCESSION NUMBER: 0000854560-01-500035 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011031 FILED AS OF DATE: 20011113 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GREAT SOUTHERN BANCORP INC CENTRAL INDEX KEY: 0000854560 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTIONS, NOT FEDERALLY CHARTERED [6036] IRS NUMBER: 431524856 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-18082 FILM NUMBER: 1781224 BUSINESS ADDRESS: STREET 1: 1451 E BATTLEFIELD CITY: SPRINGFIELD STATE: MO ZIP: 65804 BUSINESS PHONE: 4177764400 MAIL ADDRESS: STREET 1: P O BOX 9009 STREET 2: P O BOX 9009 CITY: SPRINGFIELD STATE: MO ZIP: 65808-9009 COMPANY DATA: COMPANY CONFORMED NAME: COPELAND REX A CENTRAL INDEX KEY: 0001108323 STANDARD INDUSTRIAL CLASSIFICATION: SAVINGS INSTITUTIONS, NOT FEDERALLY CHARTERED [6036] OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4/A BUSINESS ADDRESS: STREET 1: 5303 S STATE HIGHWAY NN CITY: ROGERSVILLE STATE: MO ZIP: 65742 BUSINESS PHONE: 4178874400 MAIL ADDRESS: STREET 1: 1451 E BATTLEFIELD CITY: REPUBLIC STATE: MO ZIP: 65738 4/A 1 rcopeland4a-sep01.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 1. Name and Address of Reporting Person Rex A. Copeland 4901 S. Bothwell Avenue Springfield, MO 65804 2. Issuer Name and Ticker or Trading Symbol Great Southern Bancorp, Inc. GSBC 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year October 2001 5. If Amendment, Date of Original (Month/Year) September 2001 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) (X) Other (specify below) Treasurer, Senior Vice President of Subsidiary 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.Transaction | 3.Transaction | 4.Securities Acquired (A) | 5.Amount of | 6.Qwner- | 7.Nature of | Date | Code | or Disposed (D) | Securities | ship | Indirect | (Month/ | | | Beneficially | Form: | Beneficial | Day/ | | | (A) or | | Owned at End | Direct (D) or| Owner- | Year) | Code | V | Amount | (D) | Price | of Month | Indirect (I) | ship | | | | | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- Common Stock, | | | | | | | | | $.01 par value | | | | | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned 1.Title of | 2.Conversion| 3.Trans-|4.Trans-|5.Number of| 6.Date Exer- |7.Title and Amount | 8.Price| 9.Number|10.Owner-|11. Derivative | or Exercise | action | action | Derivative| cisable and | of Underlying | of |of deriv-| ship | Nature Security | Price of | Date | Code | Securities| Expiration | Securities | Deriv- | ative | Form of | of | Deriv- | | |Acquired(A)| Date | | ative | Secur- | Deriv- | In- | Ative |(Month/ | |Disposed(D)| (Month/ | | Secur- | ities | ative | direct | Security | Day/ | | of (D) | Day/ | | ity | Bene- | Secur- | Owner- | | Year) | | | Year) | | | Ficially| ity: | ship | | | | | | | | Owned at| Direct | | | | | | Date |Expira-| Title |Amount or| | End of | (D) or | | | | | | | | Exer- |tion | |Number of| | Month |Indirect | | | |Code| V | (A) | (D) |cisable| Date | | Shares | | | (I) | | | | || | | | | | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- Option (to | | | | | | | | |Common | | | | | Purchase) | $25.7950 | 09/24/01| A | | 750 | |9/24/03|9/24/11| Stock | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- Option (to | | | | | | | | |Common | | | | | Purchase | $25.7950 | 09/24/01| A | | 750 | |9/24/04|9/24/11| Stock | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- Option (to | | | | | | | | |Common | | | | | Purchase | $25.7950 | 09/24/01| A | | 750 | |9/24/05|9/24/11| Stock | | | | | - ----------------------------------------------------------------------------------------------------------------------------------- Option (to | | | | | | | | |Common | | | | | Purchase | $25.7950 | 09/24/01| A | | 750 | |9/24/06|9/24/11| Stock | | | 10,080 | | - ----------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: /s/ Matt Snyder 11/09/2001 - -------------------------------------------- -------- Signature of Reporting Person Date (Matt Snyder, attorney-in-fact For Rex A. Copeland) -----END PRIVACY-ENHANCED MESSAGE-----