-----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, PSirglxQa9MDDLPPVCyKTqKMEpxw0oM4M9B0LO8lt2QuTCFHr+RyxQUKvpzIykWm eJ/4gPxV4kVkdRWEXdjVDA== 0001068800-03-000116.txt : 20030226 0001068800-03-000116.hdr.sgml : 20030226 20030226164323 ACCESSION NUMBER: 0001068800-03-000116 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030224 FILED AS OF DATE: 20030226 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: ROTH PHILIP R CENTRAL INDEX KEY: 0001184393 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: 1800 GARDNER EXPRESSWAY CITY: QUINCY STATE: IL ZIP: 62301 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GARDNER DENVER INC CENTRAL INDEX KEY: 0000916459 STANDARD INDUSTRIAL CLASSIFICATION: GENERAL INDUSTRIAL MACHINERY & EQUIPMENT [3560] IRS NUMBER: 760419383 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13215 FILM NUMBER: 03581325 BUSINESS ADDRESS: STREET 1: 1800 GARDNER EXPRESSWAY STREET 2: P O BOX 528 CITY: QUINCY STATE: IL ZIP: 62301 BUSINESS PHONE: 2172225400 MAIL ADDRESS: STREET 1: 1800 GARDNER EXPRESSWAY STREET 2: P O BOX 528 CITY: QUINCY STATE: IL ZIP: 62301 FORMER COMPANY: FORMER CONFORMED NAME: GARDNER DENVER MACHINERY INC DATE OF NAME CHANGE: 19931221 4 1 prr0224.txt - ------------------ ------------------------------ FORM 4 OMB APPROVAL - ------------------ ------------------------------ OMB Number: 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response ....... 0.5 ------------------------------ 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(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* Roth Philip R. - -------------------------------------------------------------------------------- (Last) (First) (Middle) Gardner Denver, Inc. 1800 Gardner Expressway - -------------------------------------------------------------------------------- (Street) Quincy IL 62301 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name AND Ticker or Trading Symbol Gardner Denver, Inc. (GDI) ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) ================================================================================ 4. Statement for Month/Day/Year February 24, 2003 ================================================================================ 5. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [ x ] Officer (give title below) [ ] Other (specify below) Vice President, Finance and Chief Financial Officer - -------------------------------------------------------------------- ================================================================================ 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 ====================================================================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. 2A. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Deemed Code ------------------------------- Owned Following (D) or Indirect 1. Transaction Execution (Instr. 8) (A) Reported Indirect Beneficial Title of Security Date Date, if any ------------ Amount or Price Transaction(s) (I) Ownership (Instr. 3) (Month/ (Month/ Code V (D) (Instr. 3 (Instr. 4)(Instr. 4) Day/Year) Day/Year) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 1/2/03 P 660(1) A 17.0800 34,787 D - ------------------------------------------------------------------------------------------------------------------------------------ 5,495(2) I 401(k) & Excess Plan - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
==================================================================================================================================== TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ====================================================================================================================================
9. Number of 10. Deriv- Owner- 2. ative ship Conver- 5. 7. Secu- Form of 11. sion Number of Title and Amount rities Deriv- Nature or 3A. Derivative 6. of Underlying 8. Bene- ative of Exer- Deemed 4. Securities Date Securities Price ficially Secu- In- cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Owned rities: 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 Secu- Trans- Indirect Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number rity action(s) (I) ship Security Secu- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) rity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Exployee Stock Option (Right to buy) 17.6850 2/24/03 A 13,300 (3) 2/24/13 Common Stk. 13,300 13,300 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: (1) Acquired 660 shares under the GDI employee stock purchase plan in January, 2003. (2) Between 6/01/02 and 2/24/03 the reporting person has acquired 464 shares under the Company's Retirement Savings Plan, a 401(k) plan, and the related Supplemental Excess Defined Contribution Plan. The information reported herein is based on a report dated as of 2/24/03 from the Plan's recordkeeper, JP Morgan/American Century. (3) The options, granted under the Company's Long-Term Incentive Plan, as amended, are exerciseable in cumulative increments of one-third each on 2/24/04, 2/24/05 and 2/24/06.
/s/ Philip R. Roth February 25, 2003 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date 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). ** 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 is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----