-----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, CzL0OJSfK8MYKss8MGrz1T7eBNyiTikWnMEGFvPxBiVfJd3O0ddoJSSVpwhg7caP ILrlmql4aA7hF1hY24LBVQ== 0001209191-04-039803.txt : 20040806 0001209191-04-039803.hdr.sgml : 20040806 20040806172755 ACCESSION NUMBER: 0001209191-04-039803 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040804 FILED AS OF DATE: 20040806 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ROBINSON HARRIETT J CENTRAL INDEX KEY: 0001196567 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-13796 FILM NUMBER: 04958969 BUSINESS ADDRESS: STREET 1: 3500 TUXEDO ROAD NW CITY: ATLANTA STATE: GA ZIP: 30305 BUSINESS PHONE: 4042665532 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: GRAY TELEVISION INC CENTRAL INDEX KEY: 0000043196 STANDARD INDUSTRIAL CLASSIFICATION: TELEVISION BROADCASTING STATIONS [4833] IRS NUMBER: 580285030 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 4370 PEACHTREE ROAD NE CITY: ALBANY STATE: GA ZIP: 30319 BUSINESS PHONE: 9128889390 MAIL ADDRESS: STREET 1: 4370 PEACHTREE ROAD NE CITY: ALBANY STATE: GA ZIP: 30319 FORMER COMPANY: FORMER CONFORMED NAME: GRAY COMMUNICATIONS SYSTEMS INC /GA/ DATE OF NAME CHANGE: 19950612 FORMER COMPANY: FORMER CONFORMED NAME: GRAY COMMUNICATIONS CORP DATE OF NAME CHANGE: 19911011 FORMER COMPANY: FORMER CONFORMED NAME: GRAY COMMUNICATIONS SYSTEMS INC DATE OF NAME CHANGE: 19880331 4 1 doc4.xml FORM 4 SUBMISSION X0202 4 2004-08-04 0 0000043196 GRAY TELEVISION INC GTN 0001196567 ROBINSON HARRIETT J 3500 TUXEDO ROAD,NW ATLANTA GA 30305 1 0 0 0 Common Class (GTN) 79500 D Common Class A (GTN.A) 558540 D Common Class A (GTN.A) 10400 D Common Class (GTN) 112950 I Spouse Common Class A (GTN.A) 403775 I Spouse Common Class (GTN) 43750 I Children Common Class A (GTN.A) 1022380 I Children Common Class A (GTN.A) 1052380 I Children Common Class (GTN) 35000 I Delta Fire & Casualty Ins. Co. Common Class A (GTN.A) 33750 I Delta Fire & Casualty Ins. Co. Common Class (GTN) 10000 I Delta Life Ins. Co. Common Class A (GTN.A) 135795 I Delta Life Ins. Co. Common Class A (GTN.A) 221706 I Bankers Fidelity Life Ins. Co. Common Class (GTN) 6000 I Georgia Casualty & Surety Co. Common Class A (GTN.A) 132354 I Georgia Casualty & Surety Co. Common Class (GTN) 72000 I Associated Casualty Ins. Co. Common Class A (GTN.A) 22000 I Associated Casualty Ins. Co. Common Class (GTN) 50000 I American Southern Ins. Co. Common Class (GTN) 3521 I Spouse 401 K Plan nqso 17.81 2000-11-19 2003-11-19 GTN.A 10000 10000 I spouse nqso 14.00 2000-11-19 2003-11-19 GTN 40000 40000 I spouse nqso 12.75 2001-11-19 2004-11-19 GTN 50000 50000 I spouse nqso 10.95 2004-09-30 2007-09-30 GTN 110000 110000 I spouse nqso 10.125 2002-05-28 2005-05-25 GTN 100000 100000 I spouse nqso 11.23 2004-01-07 2007-01-07 GTN 67000 67000 I spouse Series C Pref Stock 14.39 2002-04-23 4 J 0 36 10000.00 A 2007-04-22 2012-04-22 GTN 25017 36 I Spouse Series C Pref Stock 14.39 2002-04-23 4 J 0 54 10000.00 A 2007-04-22 2012-04-22 GTN 37526 54 D Series C Pref Stock 14.39 2002-04-23 4 J 0 36 10000.00 A 2007-04-22 2012-04-22 GTN 25017 36 I Trustee for children Series C Pref Stock 14.39 2002-04-23 4 J 0 36 10000.00 A 2007-04-22 2012-04-22 GTN 25017 36 I Trustee for children Series C Pref Stock 14.39 2002-04-23 4 J 0 175 10000.00 A 2007-04-22 2012-04-22 GTN 121612 175 I Georgia Casualty and Surety Co. Series C Pref Stock 14.39 2002-04-23 4 J 0 175 10000.00 A 2007-04-22 2012-04-22 GTN 121612 175 I Bankers Fidelity Life Insurance Co. Series C Pref Stock 14.39 2002-04-23 4 J 0 298 10000.00 A 2007-04-22 2012-04-22 GTN 207088 298 I Delta Life Insurance Co. Series C Pref Stock 14.39 2002-04-23 4 J 0 50 10000.00 A 2007-04-22 2012-04-22 GTN 34746 50 I Delta Fire & Casualty Insurance Co. Series C Pref Stock 14.39 2002-04-23 4 J 0 36 10000.00 D 2007-04-22 2012-04-22 GTN 25017 0 I Spouse In April of 2002, the Company issued Series C Preferred Stock to Mr. Robinson and certain of his affiliates in exchange for Series A and Series B Preferred Stock then held by Mr. Robinson. The Series C Preferred Stock is convertible into the Company's Common Stock ("GTN")at a conversion price of $14.39 per share. The Series C Preferred Stock is redeemable at the Company's option on or after April 22, 2007 and is subject to mandatory redemption on April 22, 2012 at a value of $10,000 per share. On August 4, 2004, Mr. Robinson sold to the Company the 36 shares of Series C Preferred Stock that he owned directly for an aggregate purchase price of $360,000 ($10,000 per share). This transaction is exempt under rule 16B-3(e). Each share of Series C Preferred Stock is convertible into a number of shares of common stock determined by dividing the liquidation preference ($10,000) by the conversion price ($14.39). Harriett J. Robinson 2004-08-06 -----END PRIVACY-ENHANCED MESSAGE-----