-----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, UrmMBOVaPYbVmfN3Z+etGYH/pP56Rq4MXsDlHIYjWYnx+90WoF8FesA/6Snmr94s NoqA+zS636j9Vqvsj4zX1g== 0000921030-04-000007.txt : 20040122 0000921030-04-000007.hdr.sgml : 20040122 20040121185633 ACCESSION NUMBER: 0000921030-04-000007 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040122 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: CRUMP RALPH E/MARJORIE CENTRAL INDEX KEY: 0001036087 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 28 TWISTED OAK CIRCLE CITY: TRUMBULL STATE: CT ZIP: 06611 MAIL ADDRESS: STREET 1: 28 TWISTED OAK CIRCLE CITY: TRUMBULL STATE: CT ZIP: 06611 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MITY ENTERPRISES INC CENTRAL INDEX KEY: 0000921030 STANDARD INDUSTRIAL CLASSIFICATION: OFFICE FURNITURE (NO WOOD) [2522] IRS NUMBER: 870448892 STATE OF INCORPORATION: UT FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-48741 FILM NUMBER: 04536279 BUSINESS ADDRESS: STREET 1: 1301 W 400 N CITY: OREM STATE: UT ZIP: 84057 BUSINESS PHONE: 8012240589 MAIL ADDRESS: STREET 1: 1301 WEST 400 NORTH CITY: OREM STATE: UT ZIP: 84057 FORMER COMPANY: FORMER CONFORMED NAME: MITY LITE INC DATE OF NAME CHANGE: 19940329 SC 13G/A 1 f13grc04.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G (Rule 13d-102) INFORMATION STATEMENT PURSUANT TO RULES 13d-1 AND 13d-2 UNDER THE SECURITIES EXCHANGE ACT OF 1934 (Amendment No. 8)1 MITY ENTERPRISES, INC. - -------------------------------- (Name of Issuer) CLASS A COMMON STOCK - ----------------------------------- (Title of Class of Securities) 606850105 - ------------------------- (Cusip Number) 1The 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 the following page(s)] Page 1 of 5 Pages CUSIP No. 606850105 13G Page 2 of 5 Pages - ----------------------------------------------------------------------------- 1. Name of reporting persons S.S. or I.R.S. identification no. of above persons Ralph E. Crump Marjorie L. Crump - ----------------------------------------------------------------------------- 2. Check the appropriate box if a member of a group* (a)[ ] Husband/Wife (b)[ x ] - ----------------------------------------------------------------------------- 3. SEC use only - ----------------------------------------------------------------------------- 4. Citizenship or place of organization USA - ----------------------------------------------------------------------------- 5. Sole Voting Power RE Crump = 132,800, ML Crump = 132,800 Number of ----------------------------- shares 6. Shared Voting Power beneficially owned by 0 each ----------------------------- reporting 7. Sole Dispositive Power person with RE Crump = 132,800, ML Crump = 132,800 ----------------------------- 8. Shared Dispositive Power 0 - ----------------------------------------------------------------------------- 9. Aggregate amount beneficially owned by each reporting person 132,800 RE Crump direct 132,800 ML Crump direct ------- 265,600 total - ----------------------------------------------------------------------------- 10. Check box if the aggregate amount in row (9) excludes certain shares* [ ] - ----------------------------------------------------------------------------- 11. Percent of class represented by amount in row 9 3.2% RE Crump direct 3.2% ML Crump direct ----- 6.3% Total - ----------------------------------------------------------------------------- 12. Type of reporting person RE Crump = IN ML Crump = IN - ---------------------------------------------------------------------------- CUSIP No. 606850105 13G Page 3 of 5 Pages Item 1(a). Name of Issuer: MITY ENTERPRISES, INC. Item 1(b). Address of Issuer's Principal Executive Offices: 1301 West 400 North Orem UT 84057 Item 2(a). Name of Person Filing: Ralph E. & Marjorie L. Crump Item 2(b). Address of Principal Business Office or, if None, Residence: 28 Twisted Oak Circle Trumbull, CT 84057 Item 2(c). Citizenship: USA Item 2(d). Title of Class of Securities: CLASS A COMMON STOCK Item 2(e). CUSIP Number: 606850105 Item 3. If this statement is filed pursuant to Rules 13d-1(b), or 13d-2(b), check whether the person filing is a: (a) [ ] Broker or Dealer registered under Section 15 of the Act, (b) [ ] Bank as defined in Section 3(a)(6) of the Act, (c) [ ] Insurance Company as defined in Section 3(a)(19) of the Act, (d) [ ] Investment Company registered under Section 8 of the Investment Company Act, (e) [ ] Investment Adviser registered under Section 203 of the Investment Advisers Act of 1940, (f) [ ] Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see 13d-1(b)(1)(ii)(F), (g) [ ] Parent Holding Company, in accordance with Rule 13d- 1(b)(1)(ii)(G); see Item 7, (h) [ ] Group, in accordance with Rule 13d-1(b)(1)(ii)(H). CUSIP No. 606850105 13G Page 4 of 5 Pages Item 4. Ownership: (a) Amount beneficially owned: RE Crump direct = 132,800 ML Crump direct = 132,800 Total 265,600 (b) Percent of Class: RE Crump direct = 3.2% ML Crump direct = 3.2% Total 6.3% Number of shares as to which such person has: RE Crump ML Crump (i) Sole power to vote or to direct the vote: 132,800 132,800 (ii) Shared power to vote or to direct the vote: (iii) Sole power to dispose or to direct the disposition of: 132,800 132,800 (iv) Shared power to dispose or to direct the disposition of: Item 5. Ownership of Five Percent or Less of a Class. If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following [ ]. Item 6. Ownership of More than Five Percent on Behalf of Another Person. If any other person is known to have the right to receive or the power to direct the receipt of dividends from, or the proceeds from the sale of, such securities, a statement to that effect should be included in response to this item and, if such interest relates to more than five percent of the class, such person should be identified. A listing of the shareholders of an investment company registered under the Investment Company Act of 1940 or the beneficiaries of employee benefit plan, pension fund or endowment fund is not required. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. If a parent holding company has filed this schedule, pursuant to Rule 13-d-1(b)(ii)(G), so indicate under Item 3(g) and attach an exhibit stating the identity and the Item 3 classification of the relevant subsidiary. If a parent holding company has filed this schedule pursuant to Rule 13d-1(c), attach an exhibit stating the identification of the relevant subsidiary. Item 8. Identification and Classification of Members of the Group. If a group has filed this schedule pursuant to Rule 13d- 1(b)(ii)(H), so indicate under Item 3(h) and attach an exhibit stating the identity and Item 3 classification of each member of the group. If a group has filed this schedule pursuant to Rule 13d-1(c), attach an exhibit stating the identity of each member of the group. CUSIP No. 606850105 13G Page 5 of 5 Pages Item 9. Notice of Dissolution of Group. Notice of dissolution of a group may be furnished as an exhibit stating the date of the dissolution of that all further filings with respect to transactions in the security reported on will be filed, if required, by member of the group, in the individual capacity. See Item 5. Item 10. Certification. The following certification shall be included if the statement is filed pursuant to Rule 13d-1(b): "By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired in the ordinary course of business and were not acquired for the purpose of and do not have the effect of changing or influencing the control of the issuer of such securities and were not acquired in connection with or as a participant in any transaction having such purpose or effect." 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: January 20, 2004 Signature: /s/ Ralph E. Crump Marjorie L. Crump ------------------------------------------------ Name/Title: Ralph E. Crump Marjorie L. Crump Director Asst Secretary The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature. -----END PRIVACY-ENHANCED MESSAGE-----