-----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, FZ6KDfhaxwu2lx8hE6aN8YV5JqjzOOhBBHUaPinzuD3I4IyVICrCjfkuwFC576RD 1wzbeMCOntmW22ZSGVxRQg== 0001292215-05-000008.txt : 20051215 0001292215-05-000008.hdr.sgml : 20051215 20051215123649 ACCESSION NUMBER: 0001292215-05-000008 CONFORMED SUBMISSION TYPE: 4/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20041215 FILED AS OF DATE: 20051215 DATE AS OF CHANGE: 20051215 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Henderson Jeffery A CENTRAL INDEX KEY: 0001302198 FILING VALUES: FORM TYPE: 4/A SEC ACT: 1934 Act SEC FILE NUMBER: 000-50925 FILM NUMBER: 051265837 BUSINESS ADDRESS: BUSINESS PHONE: 7066253045 MAIL ADDRESS: STREET 1: 597 HENDERSON BEND ROAD CITY: CALHOUN STATE: GA ZIP: 30701 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Gold Kist Inc. CENTRAL INDEX KEY: 0001292215 STANDARD INDUSTRIAL CLASSIFICATION: POULTRY SLAUGHTERING AND PROCESSING [2015] IRS NUMBER: 201163666 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 244 PERIMETER CENTER PARKWAY, N.E. CITY: ATLANTA STATE: GA ZIP: 30346 BUSINESS PHONE: 404-393-5000 MAIL ADDRESS: STREET 1: 244 PERIMETER CENTER PARKWAY, N.E. CITY: ATLANTA STATE: GA ZIP: 30346 FORMER COMPANY: FORMER CONFORMED NAME: Gold Kist Holdings Inc. DATE OF NAME CHANGE: 20040528 4/A 1 primary_doc.xml PRIMARY DOCUMENT X0202 4/A 2004-12-15 2004-12-08 0 0001292215 Gold Kist Inc. GKIS 0001302198 Henderson Jeffery A 597 HENDERSON BEND ROAD CALHOUN GA 30701 1 0 0 0 Common Stock 2004-12-08 4 A 0 61360 0 A 64417 D Common Stock 2004-12-08 4 A 0 1030 0 A 1030 I By wife Patronage Equity and Members Interest 0 2004-12-08 4 D 0 1 0 D Common Stock 0 D Patronage Equity and Members Interest 0 2004-12-08 4 D 0 1 0 D Common Stock 0 I By wife. The reporting person held patronage equity in Gold Kist Inc., a cooperative marketing association organized under the Georgia Cooperative Marketing Act ("Gold Kist Co0op"). Pursuant to a plan of conversion that was effective immediately prior to the closing of the initial public offering of the issuer's common stock, Gold Kist Co-op converted to a for profit corporation organized under the laws of Delaware by merging into the issuer. This Form 4 is being filed to report the number of shares of the issuer's common stock received by the reporting person in connection with the conversion based on (i) the amount of patronage equity in Gold Kist Co-op held by the reporting person at the closing of the conversion and (ii) the reporting person's pro rata share in the additional and supplemental distributions under the plan of conversion, which share is based the amount of business the reporting person did with Gold Kist Co-op for the five fiscal years ending June 26, 2004 and the period through the closing of the conversion. The reporting person's wife also held patronage equity in the Gold Kist Co-op, which converted into shares of the issuer's common stock pursuant to the conversion described in Footnote 2. J. David Dyson, Attorney-in-Fact 2005-12-15 -----END PRIVACY-ENHANCED MESSAGE-----