-----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, TBIM3i8JWIjhrwORA3+3Z3c9X3FY/wOWaeJqXoarY/RiGf3mgKdUgppdygd48Buh +hMviZrWnNeZfOcMyq7rhA== 0001010549-09-000329.txt : 20090429 0001010549-09-000329.hdr.sgml : 20090429 20090429180616 ACCESSION NUMBER: 0001010549-09-000329 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20090427 FILED AS OF DATE: 20090429 DATE AS OF CHANGE: 20090429 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PALM HARBOR HOMES INC /FL/ CENTRAL INDEX KEY: 0000923473 STANDARD INDUSTRIAL CLASSIFICATION: PREFABRICATED WOOD BLDGS & COMPONENTS [2452] IRS NUMBER: 591036634 STATE OF INCORPORATION: FL FISCAL YEAR END: 0331 BUSINESS ADDRESS: STREET 1: 15303 DALLAS PKWY STREET 2: STE 800 CITY: DALLAS STATE: TX ZIP: 75248 BUSINESS PHONE: 9729912922 MAIL ADDRESS: STREET 1: 15303 DALLAS PARKWAY STREET 2: STE 800 CITY: DALLAS STATE: TX ZIP: 75248 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CAPITAL SOUTHWEST CORP CENTRAL INDEX KEY: 0000017313 STATE OF INCORPORATION: TX FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-24268 FILM NUMBER: 09780434 BUSINESS ADDRESS: STREET 1: 12900 PRESTON RD STE 700 CITY: DALLAS STATE: TX ZIP: 75230 BUSINESS PHONE: 9722338242 MAIL ADDRESS: STREET 1: 12900 PRESTON RD STREET 2: SUITE 700 CITY: DALLAS STATE: TX ZIP: 75230 4 1 capital4ashbaugh042909_ex.xml X0303 4 2009-04-27 0 0000923473 PALM HARBOR HOMES INC /FL/ PHHM 0000017313 CAPITAL SOUTHWEST CORP 12900 PRESTON RD SUITE 700 DALLAS TX 75230 0 0 1 0 Common Stock Warrant (right to buy) 3.14 2009-04-27 4 J 0 286625 0 A 2009-04-27 2019-04-24 Common Stock 286625 286625 I See Footnotes The securities indicated were issued in connection with the loan of $3,000,000 made to the issuer by Capital Southwest Venture Corporation, pursuant to a senior subordinated secured promissory note. The securities indicated are held directly by Capital Southwest Venture Corporation, which is a wholly owned subsidiary of Capital Southwest Corporation. /s/ William M. Ashbaugh 2009-04-29 -----END PRIVACY-ENHANCED MESSAGE-----