-----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, JTHu9Amaqmx07gx0tNpOjmOZD470H05zyKBHNDAAhPmf9+HsWK9EVSQbYD+0Cdkx SP5IOVKdFPXoIPwjy0zRng== 0000950123-01-503253.txt : 20010607 0000950123-01-503253.hdr.sgml : 20010607 ACCESSION NUMBER: 0000950123-01-503253 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010424 FILED AS OF DATE: 20010606 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HANOVER CAPITAL MORTGAGE HOLDINGS INC CENTRAL INDEX KEY: 0001040719 STANDARD INDUSTRIAL CLASSIFICATION: MORTGAGE BANKERS & LOAN CORRESPONDENTS [6162] IRS NUMBER: 133950486 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-13417 FILM NUMBER: 1654817 BUSINESS ADDRESS: STREET 1: 90 WEST ST STREET 2: SUITE 2210 CITY: NEW YORK STATE: NY ZIP: 10006 BUSINESS PHONE: 2127325086 MAIL ADDRESS: STREET 1: 90 WEST ST STE 1508 CITY: NEW YORK STATE: NY ZIP: 10006 COMPANY DATA: COMPANY CONFORMED NAME: CLYMER JOHN A CENTRAL INDEX KEY: 0001078663 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 829 THIRD STREET CITY: HUDSON STATE: WI ZIP: 54016 4 1 y48227b4e4.txt FORM 4 1 ------------------------------ OMB APPROVAL ------------------------------ OMB Number: 3235-0287 Expires: September 30, 1998 Estimated average burden hours per response ....... 0.5 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 [_] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). (Print or Type Responses) - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Clymer John A - -------------------------------------------------------------------------------- (Last) (First) (Middle) 829 Third Street - -------------------------------------------------------------------------------- (Street) Hudson WI 54016 - -------------------------------------------------------------------------------- (City) (State) (Zip) - -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol Hanover Capital Mortgage Holdings, Inc. HCM - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) - -------------------------------------------------------------------------------- 4. Statement for Month/Year April 2001 - -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) - -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [x] Director [_] 10% Owner [_] Officer (give title below) [_] Other (specify below) -------------------------- - -------------------------------------------------------------------------------- 7. 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 - --------------------------------------------------------------------------------
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (Month/Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 0 - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------
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). (Over) SEC 1474 (7-96) 2 FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ________________________________________________________________________________
10. 9. Owner- Number ship of Form 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------- ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option Common (right to acquire) $15.00 * * Stock 2,000 2,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Options ** 4.625 8/29/99 8/28/09 Stock 2,000 2,000 D - ------------------------------------------------------------------------------------------------------------------------------------ Common Options *** 3.875 5/18/00 A 4,000 5/18/00 5/17/10 Stock 4,000 4,000 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ---------------------------------------------------------------------------------------
Explanation of Responses: /s/ John A. Clymer 5/7/01 - --------------------------------------------- ----------------------- *Signature of Reporting Person Date John A. Clymer * Subject to certain requirements, options may vest on a ratable, monthly basis over a 48 month period commencing with the month that includes the closing of the initial public offering and are exercisable at the initial public offering price of the units. Options expire one day less than ten (10) years from the date of the initial public offering. ** Options exercisable immediately and expire one day less than ten years from grant date. ** 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 provided is insufficient, see Instruction 6 for procedure. Page 2 SEC 1474 (7-96) -----END PRIVACY-ENHANCED MESSAGE-----