-----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, IFqOuFb2xe41S7XNxlIM7BY+civ/hgDZqqymvgZc6G/2JY5/SC5AcBzBnSeGAptY sueQ1B7ISodhu7VWmg18Og== 0001107049-03-000152.txt : 20030214 0001107049-03-000152.hdr.sgml : 20030214 20030214175652 ACCESSION NUMBER: 0001107049-03-000152 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021231 FILED AS OF DATE: 20030214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MILLER INDUSTRIES INC /TN/ CENTRAL INDEX KEY: 0000924822 STANDARD INDUSTRIAL CLASSIFICATION: TRUCK & BUS BODIES [3713] IRS NUMBER: 621566286 STATE OF INCORPORATION: TN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-14124 FILM NUMBER: 03568825 BUSINESS ADDRESS: STREET 1: 8503 HILLTOP DR STREET 2: STE 100 CITY: OOLTEWAH STATE: TN ZIP: 37363 BUSINESS PHONE: 4232384171 MAIL ADDRESS: STREET 1: 8503 HILLTOP DR STREET 2: STE 100 CITY: OOLTEWAH STATE: TN ZIP: 37363 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: ROBERTS RICHARD H CENTRAL INDEX KEY: 0001071950 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: PO BOX 1058 CITY: GREENVILLE STATE: TN ZIP: 37744 BUSINESS PHONE: 4236367100 MAIL ADDRESS: STREET 1: PO BOX 1058 CITY: GREENVILLE STATE: TN ZIP: 37744 5 1 robertsform5.htm FORM 5 Form 5

 

Form 5

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

ANNUAL 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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Expires: January 31, 2005

[   ]

Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b).

Estimated average burden
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[   ] Form 3 Holdings Reported  
[   ] Form 4 Transactions Reported  

1.  Name and Address of Reporting Person*

 Roberts, Richard H.

 2. Issuer Name and Ticker or Trading Symbol

Miller Industries, Inc. (MLR)

6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_X_  Director                         ___ 10% Owner
___ Officer (give              ___ Other (specify
                  title below)                     below)

  

(Last)     (First)     (Middle)

 

 8503 Hilltop Drive

 3. I.R.S. Identification
    Number
    of Reporting Person,
    if an entity
    (voluntary)		 4.  Statement for
     Month/Year

12-31-00

 (Street)

 

 Ooltewah, TN  37363

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

 

 7. Individual or Joint/Group Filing
(Check Applicable Line)
_X_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person

(City)     (State)     (Zip)

 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
    at the end of
    Issuer's
    Fiscal Year
    (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


  









 









 









 








* If the form is filed by more than one reporting person, see instruction 4(b)(v).

 

Form 5 (continued)

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. Trans-
     action
    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
    at End
    of Year
    (Instr. 4)		 10. Ownership
       of
      Derivative
      Security:
      Direct (D)
      or
      Indirect
      (I)
      (Instr. 4)		 11. Nature
      of
      Indirect
      Beneficial
      Ownership
      (Instr.
       4)
       

 

(A)

(D)

Date
Exercisable

Expiration
Date

Title

 Amount
or
Number
of Shares

Stock Options

$7.023

9/12/00

  

A5

11,148

 

(1)

9/12/10

Common Stock

11,148

   11,148 

D

 

Stock Options

$14.0825

10/18/99

  

A5

4,315

 

(2)

10/18/09

Common Stock

4,315

  

4,315 

D

 

Stock Options

$27.0625

9/14/98

  

A5

3,168

 

(3)

9/14/08

Common Stock

3,168

   3,168 

D

 

Explanation of Responses:

(1)  Options become exercisable in two equal installments on 3/12/01 and 3/12/02.
(2)  Options become exercisable in two equal installments on 4/18/00 and 4/18/01.
(3)  Options become exercisable in two equal installments on 3/14/99 and 3/14/00.

 

   /s/ Richard H. Roberts

Richard H. Roberts

**Signature of Reporting Person

2-12-03

Date

 

** 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
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