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