-----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, AQRewCv97iWRlGAtnaAppOUPooyegXBkJ1CKcFup8hu7KTvil6/vb6/5jsMMh8eV YKH31s+hxGJuRmMTsGiuwA== 0000897069-02-000131.txt : 20020414 0000897069-02-000131.hdr.sgml : 20020414 ACCESSION NUMBER: 0000897069-02-000131 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20020212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL RESEARCH CORP CENTRAL INDEX KEY: 0000070487 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-TESTING LABORATORIES [8734] IRS NUMBER: 470634000 STATE OF INCORPORATION: WI FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-52417 FILM NUMBER: 02539221 BUSINESS ADDRESS: STREET 1: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 BUSINESS PHONE: 4024752525 MAIL ADDRESS: STREET 1: 1245 Q STREET CITY: LINCOLN STATE: NE ZIP: 68508 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HAYS MICHAEL CENTRAL INDEX KEY: 0001053133 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: C/O NATIONAL RESEARCH CORP STREET 2: 1033 D STREET CITY: LINCOLN STATE: NE ZIP: 68508 BUSINESS PHONE: 4024752525 MAIL ADDRESS: STREET 1: C/O NATIONAL RESEARCH CORPORATION STREET 2: 1033 D STREET CITY: LINCOLN STATE: NE ZIP: 68508 SC 13G/A 1 pdm257a.txt SCHEDULE 13G, A-4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 4)* National Research Corporation - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, $.001 par value - -------------------------------------------------------------------------------- (Title of Class of Securities) 637372 10 3 ------------------------------------------------ (CUSIP Number) December 31, 2001 - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] Rule 13d-1(d) * 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 on 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). (Continued on following page(s)) Page 1 of 5 Pages - ------------------------------ CUSIP No. 637372 10 3 - ------------------------------ ================================================================================ 1 NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS (ENTITIES ONLY) Michael D. Hays - -------------------------------------------------------------------------------- 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 - -------------------------------------------------------------------------------- NUMBER OF 5 SOLE VOTING POWER SHARES 4,850,773 ------------------------------------------------------------ BENEFICIALLY 6 SHARED VOTING POWER OWNED BY -0- ------------------------------------------------------------ EACH 7 SOLE DISPOSITIVE POWER REPORTING 4,850,773 ------------------------------------------------------------ PERSON 8 SHARED DISPOSITIVE POWER WITH -0- - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 4,850,773 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) |_| - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 68.3% - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON (SEE INSTRUCTIONS) IN ================================================================================ Page 2 of 5 Pages - ------------------------------ CUSIP No. 637372 10 3 - ------------------------------ Item 1(a). Name of Issuer: - --------- -------------- National Research Corporation Item 1(b). Address of Issuer's Principal Executive Offices: - --------- ----------------------------------------------- 1245 "Q" Street Lincoln, Nebraska 68508 Item 2(a). Name of Person Filing: - --------- --------------------- Michael D. Hays Item 2(b). Address of Principal Business Office or, if none, Residence: - --------- ----------------------------------------------------------- 1245 "Q" Street Lincoln, Nebraska 68508 Item 2(c). Citizenship: - --------- ----------- United States Item 2(d). Title of Class of Securities: - --------- ---------------------------- Common Stock, $.001 par value Item 2(e). CUSIP Number: - --------- ------------ 637372 10 3 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or - ------- --------------------------------------------------------- 13d-2(b) or (c), check whether the person filing is a: ----------------------------------------------------- Not Applicable Item 4. Ownership (as of December 31, 2001). - ------ ----------------------------------- (a) Amount Beneficially Owned: 4,850,773 shares. (b) Percent of Class: 68.3% Page 3 of 5 Pages - ------------------------------ CUSIP No. 637372 10 3 - ------------------------------ (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote 4,850,773 shares (ii) shared power to vote or to direct the vote - 0 - (iii) sole power to dispose or to direct the disposition of 4,850,773 shares (iv) shared power to dispose or to direct the disposition of - 0 - 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. - ------ --------------------------------------------------------------- Not Applicable 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 Page 4 of 5 Pages - ------------------------------ CUSIP No. 637372 10 3 - ------------------------------ SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. 2-6-02 - ------------------------------------- Date /s/ Michael D. Hays - ------------------------------------- Signature Michael D. Hays - ------------------------------------- Name Page 5 of 5 Pages -----END PRIVACY-ENHANCED MESSAGE-----