SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
COLLINS DAVID C

(Last) (First) (Middle)
6053 W. CENTURY BOULEVARD

(Street)
LOS ANGELES CA 90045-0028

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
LEARNING TREE INTERNATIONAL INC [ LTRE ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
CEO
3. Date of Earliest Transaction (Month/Day/Year)
02/17/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
02/19/2004
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 02/17/2004 S(1) 277(2) D $17.5 3,668,924(3) I(3) See Footnote 5.
Common Stock 02/17/2004 S(1) 277(4) D $17.5 3,668,924(3) I(3) See Footnote 5.(5)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Explanation of Responses:
1. The sales reported in this Form 4 were effected pursuant to a Rule 10b5-1 trading plan entered into by the reporting person as of February 26, 2003. This Form 4/A is being filed to report the sale of certain shares disclaimed by the reporting person.
2. Shares sold by The Collins Family Foundation, a private charitable foundation of which the reporting person is a director. Beneficial ownership of such shares is disclaimed by the reporting person.
3. See Footnote 5 for explanation of ownership.
4. Shares sold by The Pegasus Foundation, a charitable support foundation of which the reporting person is a trustee. Beneficial ownership of such shares is disclaimed by the reporting person.
5. OWNERSHIP AS OF FILING DATE OF FORM 4/A: EXCLUDES, beneficial ownership of which is disclaimed: 139,918 shares held by The Collins Family Foundation of which the reporting person is a director; 192,098 shares held by The Pegasus Foundation of which the reporting person is a trustee; 12,000 vested options owned by Mary C. Adams, the reporting person's spouse as her separate property, and 197,640 shares held by the Mary C. Collins 1997 Trust as separate property of the reporting person's spouse. INCLUDES: 1,472,248 shares owned by the David C. Collins 1997 Trust as the reporting person's separate property; 122,280 shares owned by the David C. & Mary C. Collins Family Trust; and 2,074,818 shares held by DCMA Holdings, LP, of which the reporting person and Mary C. Collins are general partners. Although the shares held by DCMA Holdings, LP, are included, the reporting person disclaims beneficial ownership of such shares.
/s/ David C. Collins 11/29/2004
** 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.