-----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, Mq1d5g882ZHBnrI1X/4ZxMc6CoZHxNrMIxxYnlt8slD5d5isiLM8OsqAV7RAmO0e 1iF7pqW14yj1UE0UaSpMwg== 0001179110-05-018768.txt : 20050928 0001179110-05-018768.hdr.sgml : 20050928 20050928180956 ACCESSION NUMBER: 0001179110-05-018768 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050922 FILED AS OF DATE: 20050928 DATE AS OF CHANGE: 20050928 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: Piccini Silvio D CENTRAL INDEX KEY: 0001330659 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24548 FILM NUMBER: 051109463 BUSINESS ADDRESS: BUSINESS PHONE: (503) 570-1600 MAIL ADDRESS: STREET 1: 9275 S.W. PEYTON LANE CITY: WILSONVILLE STATE: OR ZIP: 97070 4 1 edgar.xml FORM 4 - X0202 4 2005-09-22 0 0000925178 MOVIE GALLERY INC MOVI 0001330659 Piccini Silvio D 2570 BEACON HILL DRIVE WEST LINN OR 97068 0 1 0 0 EVP-Chief Merch. Officer Hlywd Common Stock 2005-09-22 4 A 0 6250 0.00 A 16250 D These shares represent restricted stock awarded to the Reporting Person under the Movie Gallery, Inc. 2003 Stock Plan, 50% of which are subject to restrictions on transfer and forfeiture upon failure to attain specific performance objectives by the end of the Issuer's 2005 fiscal year, and 50% of which are subject to restrictions on transfer and forfeiture upon failure to attain specific performance objectives by the end of the Issuer's 2006 fiscal year. S. Page Todd, as Attorney-in-fact 2005-09-28 -----END PRIVACY-ENHANCED MESSAGE-----