-----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, QPKPpRlHYq5vqq5rOivJwMxu7BWdR98oJtyQRguOKTa5I0SAr88OAHU3/2pxWxvj BwkCDMla5ksaNGDEXspbjA== 0000019520-04-000067.txt : 20040414 0000019520-04-000067.hdr.sgml : 20040414 20040414121621 ACCESSION NUMBER: 0000019520-04-000067 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 2 CONFORMED PERIOD OF REPORT: 20040414 FILED AS OF DATE: 20040414 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: CHATTEM INC CENTRAL INDEX KEY: 0000019520 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 620156300 STATE OF INCORPORATION: TN FISCAL YEAR END: 1130 BUSINESS ADDRESS: STREET 1: 1715 W 38TH ST CITY: CHATTANOOGA STATE: TN ZIP: 37409 BUSINESS PHONE: 4238214571 MAIL ADDRESS: STREET 1: 1715 W 38TH ST CITY: CHATTANOOGA STATE: TN ZIP: 37409 FORMER COMPANY: FORMER CONFORMED NAME: CHATTEM DRUG & CHEMICAL CO DATE OF NAME CHANGE: 19790111 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: BOSWORTH ROBERT E CENTRAL INDEX KEY: 0001156142 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-05905 FILM NUMBER: 04732219 BUSINESS ADDRESS: STREET 1: C/O CHATTEM INC STREET 2: 1715 WEST 38TH STREET CITY: CHATTANOOGA STATE: TN ZIP: 37409 BUSINESS PHONE: 4238212037 MAIL ADDRESS: STREET 1: C/O CHATTEM INC STREET 2: 1715 WEST 38TH STREET CITY: CHATTANOOGA STATE: TN ZIP: 37409 4 1 bos143.xml X0201 4 2004-04-14 0 0000019520 CHATTEM INC CHTT 0001156142 BOSWORTH ROBERT E ONE UNION SQUARE CHATTANOOGA TN 37402 1 0 0 0 Common Shares 8157.000 D Common Shares 938228.000 I By Corporation Common Shares 23556.000 I By IRA Common Shares 1200.000 I By Trust FBO Child 1999 Stock Option Plan (Right to Buy) 27.2500 2004-04-14 4 A 0 2000 0 A 2005-04-14 2014-04-14 Common Shares 2000.00 2000.00 D 1999 Stock Option Plan (Right to Buy) 18.1250 2000-04-14 2009-04-14 Common Shares 2000.00 2000.00 D 1999 Stock Option Plan (Right to Buy) 6.9688 2001-04-19 2010-04-19 Common Shares 2000.00 2000.00 D 1999 Stock Option Plan (Right to Buy) 4.6600 2002-04-18 2011-04-18 Common Shares 2000.00 2000.00 D 1999 Stock Option Plan (Right to Buy) 13.5500 2003-04-17 2012-04-17 Common Shares 4000.00 4000.00 D 1999 Stock Option Plan (Right to Buy) 15.0100 2004-04-16 2013-04-16 Common Shares 2000.00 2000.00 D Call option (obligation to sell) 34.0000 2005-03-25 2005-03-25 Common Shares 100000.00 1.00 I By Corporation Put option (right to sell) 17.8800 2005-03-25 2005-03-25 Common Shares 100000.00 1.00 I By Corporation Shares held by Hamico, Inc. (charitable organization) on whose board of trustees reporting person sits. Beneficial ownership is disclaimed. Reflects shares previously owned indirectly through Chattem, Inc. 401 (k) plan Shares held by children or in trust for children of reporting person. Beneficial Ownership is disclaimed. Options vest in four equal annual installments beginning on the first exercise date. Hamico, Inc. entered into a zero-cost collar arrangement pursuant to which it wrote a covered call option and purchased a put option. Only one of the options can be in- the-money on the expiration date, at which time the in-the-money option will be exercised, and the other option will expire. If neither option is in-the-money on the expiration date, both options will expire. By: Alec Taylor, Attorney-in-fact for 2004-04-14 EX-24 3 bosworth.txt This Instrument Prepared by: MILLER & MARTIN, LLP 1000 Volunteer Building 832 Georgia Avenue Chattanooga, TN 37402-2289 LIMITED POWER OF ATTORNEY I, ROBERT E. BOSWORTH, of Lookout Mountain, Georgia, hereby appoint A. Alexander Taylor, II of Lookout Mountain, Tennessee or Hugh F. Sharber Of Chattanooga, Tennessee, as my Attorney-in-Fact. My Attorney-in-Fact shall have discretionary authority: A. To execute and file any Form 144, Form 4, Form 5, or any successor forms required to be filed with the Securities and Exchange Commission on my behalf. B. To file this Limited Power of Attorney with the Securities and Exchange Commission. A copy, which is certified by a notary public as a true copy of this instrument, shall be considered to have the same effect as the original. No party dealing with my Attorney-in-Fact shall be required to determine the validity of this instrument or any other document executed by my Attorney-in-Fact or to ascertain whether this instrument has been revoked. Any party shall be entitled to assume that this instrument has not been revoked unless such party has actual notice, either oral or written, of my death or has written notice that it has been revoked. This instrument shall be construed liberally in favor of conferring authority upon my Attorney-in-Fact but shall not be deemed to require the exercise of the discretion given by it. This instrinnent shall be governed by the laws of Tennessee. This instrument shall take effect immediately and shall not be revoked if I should become physically or mentally disabled. I reserve the right to amend or revoke this Limited Power of Attorney at any time I am not disabled and for any reason or no reason. This 5th day of November, 2001. /s/ROBERT E. BOSWORTH STATE OF TENNESSEE: COUNTY OF HAMILTON: Personally appeared before me,/s/EMILY KNOCH. Notary Public, ROBERT E. BOSWORTH, with whom I am personally acquainted, and who acnowledged that he executed the within instrument for the purposes therein contained. I declare under penalty of peIjury that the person whose name is subscribed to this instrument appears to be of sound mind and under no duress, fraud or undue influence. WITNESS my hand, at office, this 5th day of November, 2001. STATE OF TENNESSEE /s/ EMILY NOCH My Commission Expires March 28, 2005 -----END PRIVACY-ENHANCED MESSAGE-----