0001209191-11-058131.txt : 20111128 0001209191-11-058131.hdr.sgml : 20111128 20111128135204 ACCESSION NUMBER: 0001209191-11-058131 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20111117 FILED AS OF DATE: 20111128 DATE AS OF CHANGE: 20111128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CASATI ROLAND E CENTRAL INDEX KEY: 0000938870 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-33978 FILM NUMBER: 111227846 MAIL ADDRESS: STREET 1: 2801 EAST PIANO PARKWAY CITY: PLANO STATE: TX ZIP: 75074 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: ADAMS GOLF INC CENTRAL INDEX KEY: 0001059763 STANDARD INDUSTRIAL CLASSIFICATION: [3949] IRS NUMBER: 752320087 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 2801 EAST PLANO PARKWAY CITY: PLANO STATE: TX ZIP: 75074 BUSINESS PHONE: 9726739000 MAIL ADDRESS: STREET 1: 2801 EAST PLANO PARKWAY CITY: PLANO STATE: TX ZIP: 75074 3 1 c25262_3x0.xml MAIN DOCUMENT DESCRIPTION X0204 3 2011-11-17 0 0001059763 ADAMS GOLF INC ADGF 0000938870 CASATI ROLAND E 255 NORTH GREEN BAY ROAD LAKE FOREST IL 60045 0 0 0 1 See Remarks (1) Common Stock 459650 D Member of a 13(d) group owning more than 10% (1) The reporting person is a member of a Section 13(d) "group" with other shareholders of ADGF, as described in Amendment No. 4 to Schedule 13D filed with the Securities and Exchange Commission on November 17, 2011. /s/ Roland E. Casati 2011-11-28