SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
SURBAUGH STEVEN W

(Last) (First) (Middle)
1000 ALDERMAN DRIVE

(Street)
ALPHARETTA GA 30005

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CHOICEPOINT INC [ CPS ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
CFO
3. Date of Earliest Transaction (Month/Day/Year)
02/01/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
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 Following Reported Transaction(s) (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
Common stock(1) 02/01/2005 02/01/2005 A 10,000 A $46.12 50,833 D
Common stock(2) 12/31/2004 12/31/2004 A 305 A $45.99 859 I By 401(k) Plan
Common stock 13,333 I By Wife
Common stock 27 I By Daughter
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. Transaction 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 Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock option, right to buy(3) $46.12 02/01/2005 02/01/2005 A 2,168 02/01/2008 02/01/2015 common 2,168 $46.12 142,168 D
Stock option, right to buy(4) $46.12 02/01/2005 02/01/2005 A 7,832 02/01/2008 02/01/2015 common 7,832 $46.12 150,000 D
Stock option, right to buy(5) $46.12 02/01/2005 02/01/2005 A 10,000 (5) (5) common 10,000 $46.12 160,000 D
Stock option, right to buy $41.1 04/29/2005 04/29/2012 common 100,000 100,000 I By Wife
Explanation of Responses:
1. Grant of restricted shares issued pursuant to the ChoicePoint Inc. 2003 Omnibus Incentive Plan.
2. Shares acquired through the ChoicePoint Inc. 401(k) Plan during 2004 at prices ranging from $38.09 to $45.99 per share.
3. Incentive stock option granted under the ChoicePoint Inc. 2003 Omnibus Incentive Plan with 100% vesting 2/1/08, unless employment terminated, for other than cause, subsequent to 4/25/07, in which case grant will vest pro-rata.
4. Non-qualified stock option granted under the ChoicePoint Inc. 2003 Omnibus Incentive Plan with 100% vesting 2/1/08, unless employment terminated, for other than cause subsequent to 4/25/07, in which case grant will vest pro-rata.
5. Non-qualified stock option granted under the ChoicePoint Inc. 2003 Omnibus Stock Incentive Plan. Accelerated vesting based on pre-determined increases in performance and Company stock. 100% vests after seven years regardless of Company performance or stock price.
Remarks:
Steven W. Surbaugh 02/03/2005
** Signature of Reporting Person Date
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 4 (b)(v).
** 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.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.