-----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, Ox7AHMD8XDfFHciF3zv7TkqR0sqdnkzO6ykdXXpSF7OnRAHqQhHHKzpj68gESdWv dIO64eablF8FhUGkpT9S9w== 0001104659-03-007344.txt : 20030425 0001104659-03-007344.hdr.sgml : 20030425 20030425140836 ACCESSION NUMBER: 0001104659-03-007344 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030423 FILED AS OF DATE: 20030425 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PENN NATIONAL GAMING INC CENTRAL INDEX KEY: 0000921738 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 232234473 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24206 FILM NUMBER: 03664321 BUSINESS ADDRESS: STREET 1: 825 BERKSHIRE BLVD STE 200 STREET 2: WYOMISSING PROFESSIONAL CENTER CITY: WYOMISSING STATE: PA ZIP: 19610 BUSINESS PHONE: 6103732400 MAIL ADDRESS: STREET 1: 825 BERSHIRE BLVD STREET 2: SUITE 200 CITY: WYOMISSING STATE: PA ZIP: 19610 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: CARLINO PETER M CENTRAL INDEX KEY: 0001211342 RELATIONSHIP: DIRECTOR IRS NUMBER: 207342216 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 825 BERKSHIRE BLVD STREET 2: SUITE 200 CITY: WYOMISSING STATE: PA ZIP: 19610 BUSINESS PHONE: 6103732400 MAIL ADDRESS: STREET 1: 825 BERKSHIRE BLVD STREET 2: SUITE 200 CITY: WYOMISSING STATE: PA ZIP: 19610 4 1 j9807_4.htm 4

FORM 4

   o   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)

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

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 1. Name and Address of Reporting Person *



         Carlino             Peter                  M.

          (Last)             (First)             (Middle)


825 Berkshire Boulevard Suite 200

(Street)


          Wyomissing          PA            19610

               (City)            (State)           (Zip)

 

 2. Issuer Name and Ticker
    or Trading Symbol

Penn National Gaming, Inc.   PENN



 3. I.R.S. Identification
    Number of Reporting
    Person, if an entity
    (voluntary)

 

 

 4. Statement for
    Month/Day/Year

04/23/2003





 5. If Amendment, Date of
    Original (Month/Day/Year)

 

 


 6. Relationship of Reporting Person(s) to Issuer

     (Check all applicable)

   X   Director

 

   X   Officer (give title below)

 

   X   10% Owner

 

      Other (specify below)

Chairman


 7. Individual or Joint/Group
     Filing (Check Applicable Line)

      Form filed by One Reporting Person

   X   Form filed by More than One Reporting Person

 

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

 

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

04/23/03

 

J

 

264,171

D

 

5,782,177

D

Held by Carlino Family Trust(1)

Common Stock

04/23/03

 

J (2)

 

30,566

A

 

 

 

 

Common Stock

04/23/03

 

G (3)

 

1,000

D

 

 

 

 

Common Stock

04/23/03

 

G (3)

 

1,000

D

 

1,205,322 (4)

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

 

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 Underlying Securities
(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 of Derivative Securities: 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

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 Explanation of Responses:

(1) Shares are owned by the Carlino Family Trust, a ten percent owner of the issuer and indirectly by the trustees listed on Attachment A, Joint Filer Information.  The Carlino Family Trust distributed the 264,171 shares to the beneficiaries of the trust.  Peter M. Carlino is a trustee of the Carlino Family Trust and an officer and director of the issuer.

(2) Shares acquired by Peter M. Carlino as a beneficiary of the Carlino Family Trust. 

(3) Gift of shares to adult child of Peter M. Carlino.

(4) Does not include 5,782,177 shares owned by the Carlino Family Trust, of which Peter M. Carlino is a trustee.  Peter M. Carlino disclaims beneficial ownership of the shares owned by the Carlino Family Trust, and this report should not be deemed an admission that Peter M. Carlino is the beneficial owner of such securities for the purpose of section 16 or for any other purpose.

 

 

 

 

/s/ Robert S. Ippolito as attorney-in-fact for Peter M. Carlino

** Signature of Reporting Person

4/25/03

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.

 

 

http://www.sec.gov/divisions/corpfin/forms/form4.htm

Last update: 09/05/2002

 

 

Form 4 Report
Attachment A

Joint Filer Information

Name:

 

Carlino Family Trust

Address:

 

825 Berkshire Boulevard Suite 200 Wyomissing, PA 19610

Designated Filer:

 

Peter M. Carlino

Issuer & Ticker Symbol:

 

Penn National Gaming, Inc./ PENN

Date of Event Requiring Statement:

 

April 23, 2003

Signature

 

/s/ Robert S. Ippolito as attorney-in-fact for Carlino Family Trust

 

 

 

Name:

 

Harold Cramer (1)

Address:

 

825 Berkshire Boulevard Suite 200 Wyomissing, PA 19610

Designated Filer:

 

Peter M. Carlino

Issuer & Ticker Symbol:

 

Penn National Gaming, Inc./ PENN

Date of Event Requiring Statement:

 

April 23, 2003

Signature

 

/s/ Robert S. Ippolito as attorney-in-fact for Harold Cramer

 

 

 

Name:

 

Peter D. Carlino (1)

Address:

 

825 Berkshire Boulevard Suite 200 Wyomissing, PA 19610

Designated Filer:

 

Peter M. Carlino

Issuer & Ticker Symbol:

 

Penn National Gaming, Inc./ PENN

Date of Event Requiring Statement:

 

April 23, 2003

Signature

 

/s/ Robert S. Ippolito as attorney-in-fact for Peter D. Carlino

 

 

 

Name:

 

Richard J. Carlino (1)

Address:

 

825 Berkshire Boulevard Suite 200 Wyomissing, PA 19610

Designated Filer:

 

Peter M. Carlino

Issuer & Ticker Symbol:

 

Penn National Gaming, Inc./ PENN

Date of Event Requiring Statement:

 

April 23, 2003

Signature

 

/s/ Robert S. Ippolito as attorney-in-fact for Richard J. Carlino

 

 

 

Name:

 

David E. Carlino (1)

Address:

 

825 Berkshire Boulevard Suite 200 Wyomissing, PA 19610

Designated Filer:

 

Peter M. Carlino

Issuer & Ticker Symbol:

 

Penn National Gaming, Inc./ PENN

Date of Event Requiring Statement:

 

April 23, 2003

Signature

 

/s/ Robert S. Ippolito as attorney-in-fact for David E. Carlino

 

(1) The reporting person is a trustee of the Carlino Family Trust and shares investment power over the shares of the issuer owned by the Carlino Family Trust and shares voting power over certain matters.  The reporting person disclaims beneficial ownership of the shares of the issuer owned by the Carlino Family Trust and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for the purpose of Section 16 or any other purpose.

 

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