-----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, Lp57lQ+tkFEPyir1SCZxy+736Zn2+AWkpQcvjUPzKun0aJS/pwDfFf1b8rIAG78I maR+1eXssURjn9hZDtl5Zg== 0001179110-05-006789.txt : 20050329 0001179110-05-006789.hdr.sgml : 20050329 20050329195953 ACCESSION NUMBER: 0001179110-05-006789 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050325 FILED AS OF DATE: 20050329 DATE AS OF CHANGE: 20050329 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MOVIE GALLERY INC CENTRAL INDEX KEY: 0000925178 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-VIDEO TAPE RENTAL [7841] IRS NUMBER: 631120122 STATE OF INCORPORATION: DE FISCAL YEAR END: 0103 BUSINESS ADDRESS: STREET 1: 900 WEST MAIN STREET CITY: DOTHAN STATE: AL ZIP: 36301 BUSINESS PHONE: 3346772108 MAIL ADDRESS: STREET 1: 900 WEST MAIN STREET CITY: DOTHAN STATE: AL ZIP: 36301 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cousins Keith A CENTRAL INDEX KEY: 0001295392 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24548 FILM NUMBER: 05711126 BUSINESS ADDRESS: BUSINESS PHONE: (334) 677-2108 MAIL ADDRESS: STREET 1: 900 WEST MAIN STREET CITY: DOTHAN STATE: AL ZIP: 36301 4 1 edgar.xml FORM 4 - X0202 4 2005-03-25 0 0000925178 MOVIE GALLERY INC MOVI 0001295392 Cousins Keith A 9112 STURBRIDGE ROAD MONTGOMERY AL 36116 0 1 0 0 Exec.V.P. - Development Common Stock 2005-03-25 4 A 0 10000 .001 A 10747.95 D These shares represent restricted stock granted to the Reporting Person under the Movie Gallery, Inc. 2003 Stock Plan at a purchase price equal to the par value of the Issuer's Common Stock, which vest over a four year period on the anniversary date of the grant at the rate of 25% per year. Includes 747.95 shares acquired by the Reporting Person under the Movie Gallery, Inc. 2003 Employee Stock Purchase Plan on March 31, 2004 and September 30, 2004. S. Page Todd, as Attorney-in-fact 2005-03-29 -----END PRIVACY-ENHANCED MESSAGE-----