-----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, MfTQPR5oiRZKBId/yfPjNcjJODNT5ixNaowrz4qv5vUwXpn51Ct6UG8hWhERcNPZ u9O2u2ovhvTM60ibuQfpzg== 0000950152-01-000914.txt : 20010214 0000950152-01-000914.hdr.sgml : 20010214 ACCESSION NUMBER: 0000950152-01-000914 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010213 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MPW INDUSTRIAL SERVICES GROUP INC CENTRAL INDEX KEY: 0001047098 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340] IRS NUMBER: 341567260 STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-52989 FILM NUMBER: 1536027 BUSINESS ADDRESS: STREET 1: 9711 LANCASTER RAOD SE CITY: HEBRON STATE: OH ZIP: 43025 BUSINESS PHONE: 614927870 MAIL ADDRESS: STREET 1: 9711 LANCASTER RD SE CITY: HEBRON STATE: OH ZIP: 43025 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: BLACK MONTE R CENTRAL INDEX KEY: 0001054888 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TO DWELLINGS & OTHER BUILDINGS [7340] STATE OF INCORPORATION: OH FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 0 STREET 2: 9711 LANCASTER ROAD SE CITY: HEBRON STATE: OH ZIP: 43025 BUSINESS PHONE: 614927870 MAIL ADDRESS: STREET 1: 9711 LANCASTER RD SE STREET 2: 9711 LANCASTER RD SE CITY: HEBRON STATE: OH ZIP: 43025 SC 13G/A 1 l86448asc13ga.txt MPW INDUSTRIAL SERVICES GROUP, INC. SC 13G/A 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. 1)* MPW Industrial Services Group, Inc. ------------------------------------------- (Name of Issuer) Common Stock, without par value -------------------------------------------- (Title of Class of Securities) 553444 10 0 ------------------ (CUSIP Number) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). Page 1 of 4 pages 2
CUSIP NO. 553444 10 0 PAGE 2 OF 4 PAGES - ----------------------------------------------------------------------------------------------------------- | 1 | Names of Reporting Persons S.S. or I.R.S. Identification No. of Above Person | | | | | | | | | Monte R. Black | |-----|---------------------------------------------------------------------------------------------------| | 2 | Check the Appropriate Box if a Member of a Group* (a) [ ] | | | (See Instructions) ----- | | | (b) [ ] | | | ----- | |-----|---------------------------------------------------------------------------------------------------| | 3 | SEC Use Only | | | | |-----|---------------------------------------------------------------------------------------------------| | 4 | Citizenship or Place of Organization | | | | | | United States of America | |-------------------------------|-------|-----------------------------------------------------------------| | Number of | 5 | Sole Voting Power | | | | | | Shares | | 5,094,860 | | |-------|-----------------------------------------------------------------| | Beneficially | 6 | Shared Voting Power | | | | | | Owned by | | 1,182,840 (see Item 4)* | | |-------|-----------------------------------------------------------------| | Each | 7 | Sole Dispositive Power | | | | | | Reporting | | 5,094,860 | | |-------|-----------------------------------------------------------------| | Person With | 8 | Shared Dispositive Power | | | | | | | | 1,182,840 (see Item 4)* | |-------------------------------|-------|-----------------------------------------------------------------| | 9 | Aggregate Amount Beneficially Owned by Each Reporting Person | | | | | | 6,277,700 (see Item 4)* | |-----|---------------------------------------------------------------------------------------------------| | 10 | Check box if the Aggregate Amount in Row (9) Excludes Certain Shares* | | | | | | | |-----|---------------------------------------------------------------------------------------------------| | 11 | Percent of Class Represented by Amount in Row (9) | | | | | | 57.4% | |-----|---------------------------------------------------------------------------------------------------| | 12 | Type of Reporting Person* | | | | | | IN | - -----------------------------------------------------------------------------------------------------------
*SEE INSTRUCTION BEFORE FILLING OUT! Page 2 of 4 pages 3 SCHEDULE 13G ITEM 1(a). NAME OF ISSUER: MPW Industrial Services Group, Inc. ITEM 1(b). ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 9711 Lancaster Road, SE Hebron, Ohio 43025 ITEM 2(a). NAME OF PERSON FILING: Monte R. Black ITEM 2(b). ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 1400 Stringtown Road Lancaster, Ohio 43130 ITEM 2(c). CITIZENSHIP: United States of America ITEM 2(d). TITLE OF CLASS OF SECURITIES: common stock, without par value ITEM 2(e). CUSIP NUMBER: 553444 10 0 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13d-1(b), OR 13d-2(b), CHECK WHETHER THE PERSON FILING IS A: Not Applicable ITEM 4. OWNERSHIP: (a) AMOUNT BENEFICIALLY OWNED: 6,277,700* * As of December 31, 2000, Mr. Black was the beneficial owner of 5,094,860 shares of the Company's common stock, without par value ("Common Stock"). In addition, as of such date, Susan K. Black, the spouse of Mr. Black, owned 620,000 shares of Common Stock, each of Mr. Black's three children owned 5,000 shares of Common Stock, and a trust established for the benefit of Mr. Black's children (the "Trust") owned 547,840 shares of Common Stock, all of which may be deemed to be beneficially owned by Mr. Black. Mr. Black disclaims beneficial ownership of the shares owned by his spouse, children and the Trust. If the shares owned by Mr. Black's spouse, children and the Trust are included in the shares beneficially owned by him (6,277,700 shares), all such shares represented 57.4% of the outstanding Common Stock as determined by Rule 13d-3 under the Securities Exchange Act of 1934, as amended. Mr. Black beneficially held all shares, other than the shares owned by his spouse, children and the Trust, individually with sole voting and dispositive power. Mr. Black may be deemed to have shared voting and dispositive power with respect to the shares owned by his spouse, children and the Trust. Page 3 of 4 pages 4 (b) PERCENT OF CLASS: 57.4%* (c) NUMBER OF SHARES AS TO WHICH SUCH PERSON HAS: (I) SOLE POWER TO VOTE OR TO DIRECT THE VOTE: 5,094,860 (II) SHARED POWER TO VOTE OR TO DIRECT THE VOTE: 1,182,840* (III) SOLE POWER TO DISPOSE OR TO DIRECT THE DISPOSITION OF: 5,094,860 (IV) SHARED POWER TO DISPOSE OR TO DIRECT THE DISPOSITION OF: 1,182,840*
ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS: Not applicable ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON: Susan K. Black, the Trust, and each of Mr. Black's three children, have the right to direct the receipt of dividends from, or the proceeds from the sale of, 620,000, 547,840, and 5,000 shares of Common Stock, respectively. See Item 4* ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY: Not applicable ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP: Not applicable ITEM 9. NOTICE OF DISSOLUTION OF GROUP: Not applicable ITEM 10. CERTIFICATION: Not applicable SIGNATURE After reasonable inquiry to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 8, 2001 ---------------------------------- Date /s/ Monte R. Black ---------------------------------- Signature Monte R. Black ---------------------------------- Name/Title Page 4 of 4 pages -----END PRIVACY-ENHANCED MESSAGE-----