-----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, QHeoXhfURb++2gwwTMf+SItrCh/rUEcoMFnHIlxqTBClG+TrlpuRVMQ7zhG4nvoX NKtOxhYBr5YkmwdzfYweBQ== 0000950123-03-003826.txt : 20030402 0000950123-03-003826.hdr.sgml : 20030402 20030402162704 ACCESSION NUMBER: 0000950123-03-003826 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030331 FILED AS OF DATE: 20030402 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HANOVER CAPITAL MORTGAGE HOLDINGS INC CENTRAL INDEX KEY: 0001040719 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE INVESTMENT TRUSTS [6798] IRS NUMBER: 133950486 STATE OF INCORPORATION: MD FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13417 FILM NUMBER: 03637023 BUSINESS ADDRESS: STREET 1: 379 THORNALL STREET STREET 2: 2ND FLOOR CITY: EDISON STATE: NJ ZIP: 08837 BUSINESS PHONE: 732-548-0101 MAIL ADDRESS: STREET 1: 379 THORNALL STREET STREET 2: 2ND FLOOR CITY: EDISON STATE: NJ ZIP: 08837 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: BURCHETT JOHN A CENTRAL INDEX KEY: 0001055501 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: HANOVER CAPITAL MORTGAGE HOLDINGS INC STREET 2: 90 WEST ST STE 1508 CITY: NEW YORK STATE: NY ZIP: 10006 BUSINESS PHONE: 2127325086 MAIL ADDRESS: STREET 1: HANOVER CAPITAL MORTGAGE HOLDINGS INC STREET 2: 90 WEST ST STE 1508 CITY: NEW YORK STATE: NY ZIP: 10006 4 1 y85132be4.htm FORM 4 FORM 4
 

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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)
  Burchett, John A.
  Hanover Capital Mortgage Holdings, Inc. HCM
 
 
379 Thornall Street

4. Statement for (Month/Day/Year) 5. If Amendment, Date of Original (Month/Day/Year)
    4/0203
 
  (Street) 6. Relationship of Reporting Person(s) to Issuer (Check All Applicable) 7. Individual or Joint/Group Filing
(Check Applicable Line)
  Edison, NJ 08837
(City)                (State)           (Zip)
  x  Director x  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)  
        Chief Executive Officer and President
     

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)   4/02/03   S   20,000   D 7.7005     462,179     D  

                     

                     

                     

                     

                     

                     

                   

                   

                   

Page 2


 


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**   15.75     7/1/02     A   A

  Options   15.00          

  Options ***   3.875     5/18/00     A   A

             

             

             

             

             

             

             

Page 3


 


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 24,270         24,270     D  

  9-19-2001 9-19-2007   Common Stock 89,467         89,467     D  

  *** ***   Common Stock 16,400         16,400     D  

                 

                 

                 

                 

                 

                 

                 

Explanation of Responses:

** Options vest annually during the periods between 2002 and 2007 based on the achievement of certain performance targets based on the Company's stock price.

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

Note 1: In connection with a Stock Purchase Agreement between Hanover Capital Mortgage Holdings, Inc. and John A. Burchett dated March 31, 2003, the Company on March 31, 2003, repurchased 20,000 shares of its common stock from Mr. Burchett.

Mr. Burchett used the proceeds of the repurchase towards the payoff of a loan that had been extended to him by the Company. Also, this figure represents a correction from a typographical error in a previously filed form 4.

John A. Burchett   04/02/03

**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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