FORM 4 |
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 or Section 30(h) of the Investment Company Act of 1940 |
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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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
LACROSSE FOOTWEAR INC [ BOOT ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 01/02/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 12,000 | I | As Custodian for Children | |||||||
Common Stock | 2,390,755 | I | As Trustee of Voting Trust | |||||||
Common Stock | 2,400 | I | By Spouse | |||||||
Common Stock | 117,254 | I | By Voting Trust | |||||||
Common Stock | 97,750 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option (Right to Buy) | $7.7 | 01/02/2004 | A | 40,000 | (1) | 01/02/2014 | Common Stock | 40,000 | $0 | 40,000 | D | ||||
Employee Stock Option (Right to Buy) | $8.625 | (7) | 01/02/2009 | Common Stock | 3,500 | 3,500 | D | ||||||||
Employee Stock Option (Right to Buy) | $4.44 | (8) | 01/03/2010 | Common Stock | 5,000 | 5,000 | D | ||||||||
Employee Stock Option (Right to Buy) | $3.13 | (9) | 01/02/2011 | Common Stock | 25,000 | 25,000 | D | ||||||||
Employee Stock Option (Right to Buy) | $3.4 | (10) | 01/02/2012 | Common Stock | 23,350 | 23,350 | D | ||||||||
Employee Stock Option (Right to Buy) | $2.58 | (11) | 01/02/2013 | Common Stock | 30,000 | 30,000 | D | ||||||||
Employee Stock Option (Right to Buy) | $13 | (2) | 04/07/2004 | Common Stock | 7,500 | 7,500 | D | ||||||||
Employee Stock Option (Right to Buy) | $11.25 | (3) | 01/03/2005 | Common Stock | 2,500 | 2,500 | D | ||||||||
Employee Stock Option (Right to Buy) | $9.06 | (4) | 01/02/2006 | Common Stock | 3,500 | 3,500 | D | ||||||||
Employee Stock Option (Right to Buy) | $10.875 | (5) | 01/02/2007 | Common Stock | 2,500 | 2,500 | D | ||||||||
Employee Stock Option (Right to Buy) | $14.25 | (6) | 01/02/2008 | Common Stock | 2,500 | 2,500 | D |
Explanation of Responses: |
1. This option becomes exercisable in 20% increments on January 2, 2005, 2006, 2007, 2008 and 2009, respectively. |
2. This option becomes exercisable in 20% increments on April 7, 1995, 1996, 1997, 1998 and 1999, respectively. |
3. This option becomes exercisable in 20% increments on January 3, 1996, 1997, 1998, 1999 and 2000, respectively. |
4. This option becomes exercisable in 20% increments on January 2, 1997, 1998, 1999, 2000 and 2001, respectively. |
5. This option becomes exercisable in 20% increments on January 2, 1998, 1999, 2000, 2001 and 2002, respectively. |
6. This option becomes exercisable in 20% increments on January 2, 1999, 2000, 2001, 2002 and 2003, respectively. |
7. This option becomes exercisable in 20% increments on January 2, 2000, 2001, 2002, 2003 and 2004, respectively. |
8. This option becomes exercisable in 20% increments on January 3, 2001, 2002, 2003, 2004 and 2005, respectively. |
9. This option becomes exercisable in 20% increments on January 2, 2002, 2003, 2004, 2005 and 2006, respectively. |
10. This option becomes exercisable in 20% increments on January 2, 2003, 2004, 2005, 2006 and 2007, respectively. |
11. This option becomes exercisable in 20% increments on January 2, 2004, 2005, 2006, 2007 and 2008, respectively. |
By: Luke E. Sims, Attorney-In-Fact | 01/06/2004 | |
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |