-----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, QhVR3lpYVWseurIEyK9vEEWGOgisYKQu0UGz7ErZc8H0fymSiUIBe+ChByt+Y2Ie kWVhIf/jbEGFDLGaufGvBQ== 0000950124-98-006271.txt : 19981111 0000950124-98-006271.hdr.sgml : 19981111 ACCESSION NUMBER: 0000950124-98-006271 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980930 FILED AS OF DATE: 19981110 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INSURANCE AUTO AUCTIONS INC /CA CENTRAL INDEX KEY: 0000880026 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MOTOR VEHICLES & MOTOR VEHICLE PARTS & SUPPLIES [5010] IRS NUMBER: 953790111 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-19594 FILM NUMBER: 98743438 BUSINESS ADDRESS: STREET 1: 850 E ALGONQUIN RD STREET 2: STE 100 CITY: SCHAUMGURG STATE: IL ZIP: 60173 BUSINESS PHONE: 847839-3939 MAIL ADDRESS: STREET 1: 1270 WEST NORTHWEST HIGHWAY CITY: PALATINE STATE: IL ZIP: 60067 COMPANY DATA: COMPANY CONFORMED NAME: INSURANCE AUTO AUCTIONS INC /CA CENTRAL INDEX KEY: 0000880026 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MOTOR VEHICLES & MOTOR VEHICLE PARTS & SUPPLIES [5010] OFFICER IRS NUMBER: 953790111 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 850 E ALGONQUIN RD STREET 2: STE 100 CITY: SCHAUMGURG STATE: IL ZIP: 60173 BUSINESS PHONE: 847839-3939 MAIL ADDRESS: STREET 1: 1270 WEST NORTHWEST HIGHWAY CITY: PALATINE STATE: IL ZIP: 60067 4 1 FORM 4 1 ------------------------- FORM 4 OMB APPROVAL UNITED STATES SECURITIES AND EXCHANGE COMMISSION ------------------------- [ ] Check this box if no longer WASHINGTON D.C. 20549 OMB Number: 3235-0287 subject to Section 16. Form Expires: September 30, 1998 4 or Form 5 obligations may STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden continue. See Instruction 1(b). hours per response....0.5 ------------------------- 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 (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1.Name and Address of Reporting Person*| 2. Issuer Name and Ticker or Trading Symbol | 6. Relationship of Reporting Person(s) | | to Issuer | | (Check all applicable) Walsh Patrick T. | Insurance Auto Auctions, Inc - IAAI | _____ Director _____ 10% Owner - -------------------------------------------------------------------------------------------| __X__ Officer (give title below) (Last) (First) (Middle) | 3. IRS or Social | 4. Statement for | _____ Other (specify below) Insurance Auto Auctions | Security Number | Month/Year | 850 E. Algonquin Rd., Suite 100 | of Reporting | Oct. 1998 | - ---------------------------------------| Person (Voluntary) |-------------------------|---------------------------------------- (Street) | | |7. Individual or Joint/Group Filing | | | (Check Applicable Line) | | 5. If Amendment, | _X_ Form filed by One Reporting Person | | Date of Original | ___ Form filed by More than One Schaumburg IL 60173 | | (Month/Year) | Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) | 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. Owner |7. Nature (Instr. 3) | Date | Code | or Disposed of (D) | Securities | -ship | of | (Month/Day/ | (Instr. 8) | (Instr. 3, 4 and 5) | Beneficially| Form: | Indirect | Year) | | | Owned at End| Direct | Bene- | | --------------|--------------------------| of Month | (D) or | ficial | | | | Amount | (A) | Price | (Instr. 3 | Indirect| Owner- | | Code | V | | or | | and 4) | (I) | ship | | | | | (D) | | |(Instr.4)|(Instr.4) - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- Common Stock | 10-30-98 | M | | 5,000 | A | $7.00 | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- Common Stock | 10-30-98 | S | | 5,000 | D | $12.1250 | -0- | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- | | | | | | | | | - ---------------------------------------|---------------|-------|-------|--------|------|----------|-------------|---------|--------- (1) Secretary of the Company, Vice President and Secretary to the Board of Directors of Success National Bank. - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) *If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (7-96)
2
FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative | 2. Conver- |3. Trans- |4. Trans- |5. Number of |6. Date Exer- |7. Title and Amount |8. Price Security | sion or | action | action | Derivative | cisable and | of Underlying | of (Instr. 3) | Exercise | Date | Code | Securities Ac- | Expiration | Securities | Deriv- | Price of | (Month/| (Instr. 8)| quired (A) or | Date | (Instr. 3 and 4) | ative | Deriv- | Day/ | | Disposed of (D)| (Month/Day/ | | Secur- | ative | Year) | | (Instr. 3, 4, | Year) | | ity | Security | | | and 5) | | | (Instr. 5) | | | | |-------------------------------------| | | | | |Date |Expira- | | Amount or | | | |-------------------------------|Exer- |tion | Title | Number of | | | | Code | V | (A) |(D) |cisable|Date | | Shares | | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ Employee Stock Option | | | | | | | | |Common | | (right to buy) | $7.00 | 10/30/98 | M | | | 5,000 |11/8/97|11/7/05 | Stock | 5,000 | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------|-------------|----------|-------|----|--------|---------|-------|--------|--------|-----------|------------ | | | | | | | | | | | - ------------------------------------------------------------------------------------------------------------------------------------ 9. Number of | 10. Ownership | 11. Nature of Derivative | Form of | Indirect Securities | Derivative | Beneficial Beneficially | Security: | Ownership Owned at End | Direct (D) | (Instr. 4) of Month | or Indirect (I) | (Instr. 4) | (Instr. 4) | | | - ------------------|------------------------|------------------------------ 42,500 | D | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - ------------------|------------------------|------------------------------ | | - -------------------------------------------------------------------------- Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Patrick T. Walsh 11/10/98 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). --------------------- --------------- **Signature of Date Reporting Person Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this Page 2 form are not required to respond unless the form displays a currently valid OMB Number. SEC 1474 (7/96)
-----END PRIVACY-ENHANCED MESSAGE-----