4 1 y66956e4.htm FORM 4 FOR 12/13/2002 REPORTING PERIOD: KAPLAN FORM 4 FOR 12/13/2002 REPORTING PERIOD: KAPLAN
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, DC 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(h) of the Investment Company Act of 1940

o 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*
(Last, First, Middle)
2. Issuer Name and Ticker or
Trading Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Kaplan, Thomas P
  Hanover Capital Mortgage Holdings, Inc. HCM
 
  229 East 79th Street, Apt 14A
4. Statement for (Month/Day/Year) 5. If Amendment, Date of Original (Month/Day/Year)
    12/13/02
 
  (Street) 6. Relationship of Reporting Person(s) to Issuer (Check All Applicable) 7. Individual or Joint/Group Filing
(Check Applicable Line)
  New York, NY 10021
(City)                (State)           (Zip)
  o  Director o  10% Owner   x Form filed by One Reporting Person
    x  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)  
        Managing Director
     

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).
 

 


 


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
Transactions(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 (See Note 1)   12/13/02   D   34,975   D 6.9136     45,819     D  

                     

                     

                     

                     

                     

                     

                   

                   

                   

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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)

                      Code V   (A) (D)

  Options *   4.625          

  Options **   3.875          

             

             

             

             

             

             

             

             

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Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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 of
Derivative Security:
Direct (D) or Indirect (I)

(Instr. 4)
11. Nature of
Indirect
Beneficial
Ownership

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

  * *   Common Stock 11,666         11,666     D  

  ** **   Common Stock 11,480         11,480     D  

                 

                 

                 

                 

                 

                 

                 

                 

Explanation of Responses:

* Grant of options exercisable as follows: one-third at 7/29/00, one-third at 7/29/01 and one-third at 7/29/02 and expire 7/28/09

** Grant of options exercisable as follows: one-third at 5/18/01, one-third at 5/18/02 and one-third at 5/18/03 and expire 5/17/10

Note 1: In connection with a Stock Purchase Agreement between Hanover Capital Mortgage Holdings, Inc. and Thomas P. Kaplan dated December 13, 2002, the Company on December 13, 2002, repurchased 34,975 shares of its common stock from Thomas P. Kaplan. Mr. Kaplan used the proceeds of the repurchase to repay in full a loan that had been extended to him by the Company. As a result of this transaction, there are no outstanding loans between Mr. Kaplan and the Company.

/s/ Thomas P. Kaplan   12/16/02

**Signature of Reporting Person
 
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 is insufficient, see Instruction 6 for procedure.
 

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