SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
ROBINSON J MACK

(Last) (First) (Middle)
4370 PEACHTREE ROAD,NE

(Street)
ATLANTA GA 30319

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
GRAY TELEVISION INC [ GTN ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
Chairman & CEO
3. Date of Earliest Transaction (Month/Day/Year)
08/11/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock (GTN) 112,950 D
Common Class A Stock (GTN.A) 403,775 D
Common Stock (GTN) 79,500 I Spouse
Common Class A Stock (GTN.A) 08/11/2004 P 10,000 A $10.86 568,540 I Spouse
Common Class A Stock (GTN.A) 10,400 I Spouse
Common Stock (GTN) 43,750 I Spouse as Trustee for Children
Common Class A Stock (GTN.A) 08/12/2004 P 10,000 A $11.02 1,062,380 I Spouse as Trustee for Children
Common Stock (GTN) 35,000 I Delta Fire & Casualty Ins. Co.
Common Class A Stock (GTN.A) 33,750 I Delta Fire & Casualty Ins. Co.
Common Stock (GTN) 10,000 I Delta Life Ins. Co.
Common Class A Stock (GTN.A) 135,795 I Delta Life Ins. Co.
Common Class A Stock (GTN.A) 221,706 I Bankers Fidelity Life Ins. Co.
Common Stock (GTN) 6,000 I Georgia Casualty & Surety Co.
Common Class A Stock (GTN.A) 132,354 I Georgia Casualty & Surety Co.
Common Stock (GTN) 72,000 I Assoc. Casualty Insurance Co.
Common Class A Stock (GTN.A) 22,000 I Assoc. Casualty Insurance Co.
Common Stock (GTN) 50,000 I American Southern Insurance Co.
Common Class A Stock (GTN.A) 50,200 I Gulf Capital Services, Ltd.
Common Stock (GTN) 3,521(1) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
nqso $17.81 11/19/2000 11/19/2003 GTN.A 10,000 10,000 D
nqso $14 11/19/2000 11/19/2003 GTN 40,000 40,000 D
nqso $12.75 11/19/2001 11/19/2004 GTN 50,000 50,000 D
nqso $10.95 09/30/2004 09/30/2007 GTN 110,000 110,000 D
nqso $10.125 05/25/2002 05/25/2005 GTN 100,000 100,000 D
nqso $11.23 01/07/2004 01/07/2007 GTN 67,000 67,000 D
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 37,526(3) 54 I Spouse
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 25,017(3) 36 I Spouse as Trustee for Children
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 25,017(3) 36 I Spouse as Trustee for Children
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 121,612(3) 175 I Georgia Casualty and Surety Co.
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 121,612(3) 175 I Bankers Fidelity Life Insurance Co.
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 207,088(3) 298 I Delta Life Insurance Co.
Series C Pref Stock $14.39(2) 04/22/2007 04/22/2012 GTN 34,746(3) 50 I Delta Fire & Casualty Insurance Co.
Explanation of Responses:
1. Held in 401K plan.
2. 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.
3. 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).
Remarks:
J. Mack Robinson 08/13/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
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