-----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, LkQDiwnQaJMPtfM16MEtc09dJg4j1OXr9qBzIw3r5U54IMQGkSFFQK2l8OVmZG2i ceixdxysmXSFC9PvhG1nQA== 0000899078-03-000154.txt : 20030313 0000899078-03-000154.hdr.sgml : 20030313 20030313165227 ACCESSION NUMBER: 0000899078-03-000154 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020514 FILED AS OF DATE: 20030313 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FELCOR LODGING TRUST INC CENTRAL INDEX KEY: 0000923603 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 752541756 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-14236 FILM NUMBER: 03602776 BUSINESS ADDRESS: STREET 1: 545 E JOHN CARPENTER FREEWAY STREET 2: SUITE 1300 CITY: IRVING STATE: TX ZIP: 75062 BUSINESS PHONE: 9724444900 MAIL ADDRESS: STREET 1: 545 E JOHN CARPENTER FREEWAY STREET 2: SUITE 1300 CITY: IRVING STATE: TX ZIP: 75062 FORMER COMPANY: FORMER CONFORMED NAME: FELCOR SUITE HOTELS INC DATE OF NAME CHANGE: 19940523 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: MATHEWSON ROBERT A CENTRAL INDEX KEY: 0001186251 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: C/O FELCOR LODGING TRUST INC STREET 2: 595 E. JOHN CARPENTER FRWY #1300 CITY: IRVING STATE: TX ZIP: 75062 BUSINESS PHONE: 9724444908 MAIL ADDRESS: STREET 1: FELCOR LODGING TRUST INC STREET 2: 595 E. JOHN CARPENTER FRWY #1300 CITY: IRVING STATE: TX ZIP: 75062 3/A 1 form3amended.txt
FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL Washington, D.C. 20549 OMB Number 3235-0104 Expires: December 31, 2005 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Estimated average burden 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 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol 6. If Amendment, of Reporting Person Requiring Statement Date of Original (Month/Day/Year) (Month/Day/Year) Mathewson Robert A. 5/14/02 FelCor Lodging Trust Incorporated (FCH) 09/11/02 - ------------------------------------------------------------------------------------------------------------------------------------ (Last) (First) (Middle) 3. I.R.S. 5. Relationship of Reporting Person(s) 7. Individual or Joint / Identification to Issuer Group Filing (Check 545 E. John Carpenter Frwy. Number of (Check all applicable) applicable line) Suite 1300 Reporting Person - -------------------------------- (voluntary) X Director 10% Owner X Form filed by One (Street) --- --- --- Reporting Person Irving TX 75062-0000 Officer Other - -------------------------------- --- (give title --- (specify Form filed by More (City) (State) (Zip) below) below) --- than One Reporting Person ---------------------------- Table I-- Non-Derivative Securities Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial (Instr. 4) Beneficially Owned Direct (D) Ownership (Instr. 5) (Instr. 4) or Indirect (I) (Instr. 5) Common Stock 4,022 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12,000 I Held by RGC Leasing, Inc. (2) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 106,945 I Held by RGC, Inc. (2) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ 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 5 (b)(v). Page 1 FORM 3 (continued) Table II-- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 2. Date Exer- 3. Title and Amount of 4. Conver- 5. Ownership 6. Nature of Derivative cisable and Securities Underlying sion or Form of Indirect Security Expiration Derivative Security Exercise Derivative Beneficial (Instr. 4) Date (Instr. 4) Derivative Security: Ownership (Month/Day/ Security Direct (D) or (Instr. 5) Year) Indirect (I) (Instr. 5) ---------------------------------------------------------------------------------------------------------------- Date Expiration Title Amount or Exercisable Date Number of Shares Series A Preferred Stock Immed. Common Stock 7,752 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Units Immed. Common Stock 208,333 (1) I Held by RGC Leasing, Inc.(2) - ------------------------------------------------------------------------------------------------------------------------------------ Common Units Immed. Common Stock 817,105 (1) I Held by RGC, Inc.(2) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) Represents the number of shares of Common Stock issuable upon redemption of a like number of common units of limited partnership interest in FelCor Lodging Limited Partnership. (2) Mr. Mathewson is a director and stockholder and the President of these entities. ** Intentional misstatements of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78FF(a). By: /s/ Robert A. Mathewson 3/13/03 ----------------------------- -------------- Note: File three copies of this Form, one of which must be manually signed. **Signature of reporting person Date If space provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB number. Page 2
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