-----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, VOPENem62eX5y2uBp73jAGlm6QdxRuXlu35DsE3h7FP9yPIg//GWX8gQ4pj4Lgnt ZBwpYfaABxg1tuRrZ+Qlvw== 0000005513-03-000079.txt : 20030903 0000005513-03-000079.hdr.sgml : 20030903 20030903145543 ACCESSION NUMBER: 0000005513-03-000079 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20030903 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: UNUMPROVIDENT CORP CENTRAL INDEX KEY: 0000005513 STANDARD INDUSTRIAL CLASSIFICATION: ACCIDENT & HEALTH INSURANCE [6321] IRS NUMBER: 621598430 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1 FOUNTAIN SQUARE CITY: CHATTANOOGA STATE: TN ZIP: 37402 BUSINESS PHONE: 2077702211 MAIL ADDRESS: STREET 1: 1 FOUNTAIN SQUARE CITY: CHATTANOOGA STATE: TN ZIP: 37402 FORMER COMPANY: FORMER CONFORMED NAME: PROVIDENT COMPANIES INC /DE/ DATE OF NAME CHANGE: 19961204 FORMER COMPANY: FORMER CONFORMED NAME: PROVIDENT LIFE & ACCIDENT INSURANCE CO OF AMERICA DATE OF NAME CHANGE: 19950407 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MADEJA PETER C CENTRAL INDEX KEY: 0001239416 FILING VALUES: FORM TYPE: 5/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-11294 FILM NUMBER: 03878921 BUSINESS ADDRESS: STREET 1: UNUMPROVIDENT CORP STREET 2: 1 FOUNTAIN SQUARE CITY: CHATTANOOGA STATE: TN ZIP: 37402 MAIL ADDRESS: STREET 1: UNUMPROVIDENT CORP STREET 2: 1 FOUNTAIN SQUARE CITY: CHATTANOOGA STATE: TN ZIP: 37402 5/A 1 mad174.xml X0201 5/A 2000-12-31 2001-02-13 0 0 0 0000005513 UNUMPROVIDENT CORP UNM 0001239416 MADEJA PETER C 1 FOUNTAIN SQUARE CHATTANOOGA TN 374021307 0 1 0 0 Senior Vice President Common Stock 14845.00 D Phantom Stock/Dividend Equivalent Rights (Prem.) 0.00 2000-12-31 5 A 0 4.74 0 A Common Stock 4.74 4.74 D Phantom Stock/Dividend Equivalent Rights (Purch.) 0.00 2000-12-31 5 A 0 11.08 0 A Common Stock 11.08 11.08 D This amount was reported as 15,654 on the original Form 5 due to the inclusion of 809 shares of phantom stock. All but 15.82 of those shares of phantom stock were to have been reported on Table II of prior forms, and those forms have now been amended to do so. This amendment corrects the error by moving the reporting for the 15.82 shares of phantom stock to Table II of this form. Conversion is one for one. These shares were acquired under the Company's Management Incentive Compensation Plan at a range of prices on quarterly dividend dates. Under the Company's Management Incentive Compensation Plan, when a Participant receives an Award, that Award may be converted into Phantom Shares, some of which are immediately vested and some of which are subject to forfeiture. Each Phantom Share is credited with a Dividend Equivalent which is converted into a Phantom Share with the same characteristics as the original Phantom Share. The shares reported on this line are subject to forfeiture during a three-year period following the conversion of the MICP Award to which they relate into Performance Shares. However, the Committee retains discretion to pay such forfeited shares to the Participant. The Participant elects to receive payment for the shares by specifying a date that is the earlier of (i) at least three years after the date the deferred portion of the Award was converted into Performance Shares or (ii) as soon as practicable after the date on which the Participant ceases to be an employee of the Company for any reason. A Part icipant may elect to extend the date for payment of Performance Shares so long as the election is made at least six months prior to the then-current payment date. Under the Company's Management Incentive Compensation Plan, when a Participant receives an Award, that Award may be converted into Phantom Shares, some of which are immediately vested and some of which are subject to forfeiture. Each Phantom Share is credited with a Dividend Equivalent which is converted into a Phantom Share with the same characteristics as the original Phantom Share. The shares reported on this line are not subject to forfeiture under the Plan. The Participant elects to receive payment for the shares by specifying a date that is the earlier of (i) at least three years after the date the deferred portion of the Award was converted into Performance Shares or (ii) as soon as practicable after the date on which the Participant ceases to be an employee of the Company for any reason. A Participant may elect to extend the date for payment of Performance Shares so long as the election is made at least six months prior to the then-current payment date. By: Jo C. Dearing on behalf of Peter C. Madeja 2003-09-03 -----END PRIVACY-ENHANCED MESSAGE-----