-----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, LJYcEXzGwqZWSTuTbFMRXwlwbuaQtCJsH3vRtFgwxG77VzogOX8Q7uAcotFr2aGz tevdOUkJpcO/bQO7SeNN4Q== 0000911916-97-000019.txt : 19970222 0000911916-97-000019.hdr.sgml : 19970222 ACCESSION NUMBER: 0000911916-97-000019 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970214 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SHOE CARNIVAL INC CENTRAL INDEX KEY: 0000895447 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-SHOE STORES [5661] IRS NUMBER: 351736614 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-42925 FILM NUMBER: 97532105 BUSINESS ADDRESS: STREET 1: 8233 BAUMGART ROAD CITY: EVANSVILLE STATE: IN ZIP: 47711 BUSINESS PHONE: 8128674039 MAIL ADDRESS: STREET 1: 8233 BAUMGART RD CITY: EVANSVILLE STATE: IN ZIP: 47711 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: POTTS ARTHUR G JR CENTRAL INDEX KEY: 0001033307 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: TWO STAMFORD PLAZA STREET 2: 281 TRESSER BLVD CITY: STAMFORD STATE: CT ZIP: 06904-1216 BUSINESS PHONE: 2033272333 MAIL ADDRESS: STREET 1: TWO STAMFORD PLAZA STREET 2: 281 TRESSER BLVD P O BOX 1214 CITY: STAMFORD STATE: CT ZIP: 06904-1214 SC 13G/A 1 ARTHUR G. POTTS, JR.'S SC 13G/A SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 3)* SHOE CARNIVAL, INC. (Name of Issuer) COMMON STOCK, WITHOUT PAR VALUE (Title of Class of Securities) 824889 10 9 (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). (Continued on following page(s)) Page 1 of 11 Pages CUSIP No. 824889 10 9 1. Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person J. Wayne Weaver 2. Check the appropriate box if a member of a group [ ] a [X] b 3. 4. Citizenship or Place of Organization United States of America 5. Sole Voting Power 2,000,000 shares 6. Shared Voting Power 833,230 shares 7. Sole Dispositive Power 2,000,000 shares 8. Shared Dispositive Power 833,230 shares 9. Aggregate Amount Beneficially Owned by Each Reporting Person 4,833,230 shares{(1)} 10. Check box if the Aggregate Amount in Row (9) Excludes Certain Shares __________________ (1) Includes 2,000,000 shares owned by Mr. Weaver's spouse. Page 2 of 11 Pages 11. Percent of Class Represented by Amount in Row 9 37.1% 12. Type of Reporting Person IN Page 3 of 11 Pages CUSIP No. 824889 10 9 1. Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person Delores B. Weaver 2. Check the appropriate box if a member of a group [ ] a [X] b 3. 4. Citizenship or Place of Organization United States of America 5. Sole Voting Power 2,000,000 shares 6. Shared Voting Power 833,230 shares 7. Sole Dispositive Power 2,000,000 shares 8. Shared Dispositive Power 833,230 shares 9. Aggregate Amount Beneficially Owned by Each Reporting Person 4,833,230 shares{(1)} 10. Check box if the Aggregate Amount in Row (9) Excludes Certain Shares __________________ (1) Includes 2,000,000 shares owned by Mrs. Weaver's spouse. Page 4 of 11 Pages 11. Percent of Class Represented by Amount in Row 9 37.1% 12. Type of Reporting Person IN Page 5 of 11 Pages CUSIP No. 824889 10 9 1. Name of Reporting Person S.S. or I.R.S. Identification No. of Above Person Arthur G. Potts, Jr., Trustee 2. Check the appropriate box if a member of a group [ ] a [X] b 3. 4. Citizenship or Place of Organization United States of America 5. Sole Voting Power 0 shares 6. Shared Voting Power 0 shares 7. Sole Dispositive Power 0 shares 8. Shared Dispositive Power 0 shares 9. Aggregate Amount Beneficially Owned by Each Reporting Person 0 shares 10. Check box if the Aggregate Amount in Row (9) Excludes Certain Shares 11. Percent of Class Represented by Amount in Row 9 0% 12. Type of Reporting Person 00 Page 6 of 11 Pages ITEM 1(A).NAME OF ISSUER. Shoe Carnival, Inc. ITEM 1(B).ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES. 8233 Baumgart Road Evansville, Indiana 47711 ITEM 2(A).NAME OF PERSON FILING. (i) J. Wayne Weaver (ii) Delores B. Weaver (iii)Arthur G. Potts, Jr., Trustee ITEM 2(B).ADDRESS OF PRINCIPAL BUSINESS OFFICE, OR, IF NONE, RESIDENCE. (i) J. Wayne Weaver 8233 Baumgart Road Evansville, Indiana 47711 (ii) Delores B. Weaver 8233 Baumgart Road Evansville, Indiana 47711 (iii)Arthur G. Potts, Jr., Trustee Two Stamford Plaza 10th Floor, P.O. Box 1214 Stamford, Connecticut 06904-1214 ITEM 2(C).CITIZENSHIP. (i) United States of America (ii) United States of America (iii)United States of America ITEM 2(D).TITLE OF CLASS OF SECURITIES. Common Stock, without par value ITEM 2(E).CUSIP NUMBER. 824889 10 9 ITEM 3.IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(B) OR 13D-2(B): Not Applicable ITEM 4.OWNERSHIP. ITEM 4(A).AMOUNT BENEFICIALLY OWNED: (i) J. Wayne Weaver - 4,833,230 shares{(1)} (ii) Delores B. Weaver - 4,833,230 shares{(2)} (iii)Arthur G. Potts, Jr., Trustee - 0 shares ITEM 4(B).PERCENT OF CLASS: (i) J. Wayne Weaver - 37.1% (ii) Delores B. Weaver - 37.1% (iii)Arthur G. Potts, Jr., Trustee - 0% ITEM 4(C).NUMBER OF SHARES AS TO WHICH SUCH PERSON HAS: (i) sole power to vote or direct the vote: (i) J. Wayne Weaver - 2,000,000 shares (ii) Delores B. Weaver - 2,000,000 shares (iii)Arthur G. Potts, Jr., Trustee - 0 shares (ii) shared power to vote or to direct the vote: (i) J. Wayne Weaver - 833,230 shares (ii) Delores B. Weaver - 833,230 shares (iii)Arthur G. Potts, Jr., Trustee - 0 shares (iii)sole power to dispose or to direct the disposition of: (i) J. Wayne Weaver - 2,000,000 shares (ii) Delores B. Weaver - 2,000,000 shares (iii)Arthur G. Potts, Jr., Trustee - 0 shares __________________ (1) Includes 2,000,000 shares owned by Mr. Weaver's spouse. (2) Includes 2,000,000 shares owned by Mrs. Weaver's spouse. Page 7 of 11 Pages (iv) shared power to dispose or to direct the disposition of: (i) J. Wayne Weaver - 833,230 shares (ii) Delores B. Weaver - 833,230 shares (iii)Arthur G. Potts, Jr., Trustee - 0 shares ITEM 5.OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. The trust for which Mr. Potts was a trustee was terminated on January 1, 1996, and the shares have been distributed to the beneficiaries. At this time, none of the trust beneficiaries own more than five percent of the shares of Shoe Carnival, Inc. 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 8 of 11 Pages 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. Date: February ____, 1997 J. Wayne Weaver Page 9 of 11 Pages 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. Date: February ____, 1997 Delores B. Weaver Page 10 of 11 Pages 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. Date: February 7, 1997 /s/ Arthur G. Potts, Jr. Arthur G. Potts, Jr., Trustee Page 11 of 11 Pages -----END PRIVACY-ENHANCED MESSAGE-----