SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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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OMB Number: 3235-0362
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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).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
YARMUTH WILLIAM B

(Last) (First) (Middle)
9510 ORMSBY STATION ROAD
SUITE 300

(Street)
LOUISVILLE KY 40223

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ALMOST FAMILY INC [ AFAM ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
CEO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2004
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock 12/16/2004 G 5,000 D (1) 0(1) D
Common Stock 12/21/2004 G 5,000 D (1) 200,659 D
Common Stock 126,427 I Spouse
Common Stock(4) 2,962 I By self as CO-TTEE for Irrevocable Trust(4)
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Options(2) $2.625 12/14/2000 10/22/2005 Common Stock 15,000 15,000 I Spouse
Options(2) $2.1875 03/05/2001 03/04/2009 Common Stock 15,000 15,000 I Spouse
Options(2) $2.1875 03/05/2002 03/04/2009 Common Stock 5,000 5,000 I Spouse
Options(3) $4.25 02/05/2001 02/04/2011 Common Stock 5,000 5,000 I Spouse
Options(3) $4.25 02/05/2002 02/04/2011 Common Stock 5,000 5,000 I Spouse
Options(3) $4.25 02/05/2003 02/04/2011 Common Stock 5,000 5,000 I Spouse
Options(3) $4.25 02/05/2004 02/04/2011 Common Stock 5,000 5,000 I Spouse
Options(5) $2.625 12/14/2000 10/24/2005 Common Stock 8,000 8,000 D
Options(2) $2.625 12/14/2000 10/24/2005 Common Stock 17,000 17,000 D
Options(5) $2.625 12/14/2000 01/02/2006 Common Stock 25,000 25,000 D
Options(2) $2.187 03/05/2001 03/04/2009 Common Stock 75,000 75,000 D
Options(2) $2.1875 03/05/2002 03/04/2009 Common Stock 25,000 25,000 D
Options(6)(2) $4.25 02/05/2001 02/04/2011 Common Stock 100,000 100,000 D
Explanation of Responses:
1. These shares were disposed of by a bona fide gift. 200,659 shares were beneficially owned directly at 12/31/04.
2. Granted pursuant to the 1991 Long Term Incentive Stock Option Plan.
3. Granted pursuant to the 2000 Stock Option Plan.
4. 2,962 shares consist of 2 individual trust FBO J.J. Yarmuth and Jacob J. Yarmuth
5. Granted pursuant to the 1987 Non-Qualified Stock Option Plan.
6. These options were vested in four equal annual installments beginning on 2/5/01.
William B. Yarmuth 02/14/2005
** 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.