-----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, V/s4zA3srKRrCVzf/fTWtxHiuEWQJBwbMUSIJ89hmMPRAww3NT6AJedWd3LWxmLU 29dCJuxobJI8M9kHGQbK9w== 0001068800-02-000403.txt : 20021226 0001068800-02-000403.hdr.sgml : 20021225 20021226124913 ACCESSION NUMBER: 0001068800-02-000403 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021223 FILED AS OF DATE: 20021226 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: JACOBSEN JAMES C CENTRAL INDEX KEY: 0001179450 RELATIONSHIP: OFFICER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 600 KELLWOOD PARKWAY CITY: CHESTERFIELD STATE: MO ZIP: 63017 BUSINESS PHONE: 3145763100 MAIL ADDRESS: STREET 1: 600 KELLWOOD PARKWAY CITY: CHESTERFIELD STATE: MO ZIP: 63017 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: KELLWOOD CO CENTRAL INDEX KEY: 0000055080 STANDARD INDUSTRIAL CLASSIFICATION: WOMEN'S, MISSES', AND JUNIORS OUTERWEAR [2330] IRS NUMBER: 362472410 STATE OF INCORPORATION: DE FISCAL YEAR END: 0430 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07340 FILM NUMBER: 02868851 BUSINESS ADDRESS: STREET 1: 600 KELLWOOD PKWY STREET 2: P O BOX 14374 CITY: CHESTERFIELD STATE: MO ZIP: 63017 BUSINESS PHONE: 3145763100 MAIL ADDRESS: STREET 1: 600 KELLYWOOD PKWY STREET 2: P O BOX 14374 CITY: ST LOUIS STATE: MO ZIP: 63178 4 1 jcj1223.txt - ------------------ ------------------------------ FORM 4 OMB APPROVAL - ------------------ ------------------------------ OMB Number: 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response ....... 0.5 ------------------------------ 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 [ ] CHECK THIS BOX IF NO LONGER SUBJECT TO SECTION 16. FORM 4 OR FORM 5 OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(b). (Print or Type Responses) ================================================================================ 1. Name and Address of Reporting Person* Jacobsen James C. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 600 Kellwood Parkway - -------------------------------------------------------------------------------- (Street) Chesterfield MO 63017 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name AND Ticker or Trading Symbol Kellwood Company KWD ================================================================================ 3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) ================================================================================ 4. Statement for Month/Day/Year 12/23/02 ================================================================================ 5. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) Director 10% Owner - ----- ----- X Officer (give title below) Other (specify title below) - ----- ----- VICE CHAIRMAN - -------------------------------------------------------------------- ================================================================================ 7. 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 ====================================================================================================================================
4. 5. 6. Own- Securities Acquired (A) or Amount of ership 3. Disposed of (D) Securities Form: 7. 2A. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Deemed Code ------------------------------ Owned Following (D) or Indirect 1. Transaction Execution (Instr. 8) (A) Reported Indirect Beneficial Title of Security Date Date, if any ------------ Amount or Price Transaction(s) (I) Ownership (Instr. 3) (Month/ (Month/ Code V (D) (Instr. 3 (Instr. 4) (Instr. 4) Day/Year) Day/Year) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 12/23/02 G 1,576 D 37,406 D - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== 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). POTENTIAL PERSONS WHO ARE TO RESPOND TO THE COLLECTION OF INFORMATION CONTAINED IN THIS FORM ARE NOT REQUIRED TO RESPOND UNLESS THE FORM DISPLAYS A CURRENTLY VALID OMB CONTROL NUMBER
==================================================================================================================================== TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ====================================================================================================================================
9. Number of 10. Deriv- Owner- 2. ative ship Conver- 5. 7. Secu- Form of 11. sion Number of Title and Amount rities Deriv- Nature or 3A. Derivative 6. of Underlying 8. Bene- ative of Exer- Deemed 4. Securities Date Securities Price ficially Secu- In- cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of Owned rity: direct Price Trans- tion action or Disposed Expiration Date ---------------- Deriv- Following Direct Bene- 1. of action Date, Code of (D) (Month/Day/Year) Amount ative Reported (D) or ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secu- Trans- Indirect Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number rity action(s) (I) ship Security Secu- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) rity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ James C. Jacobsen 12/26/02 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. -----END PRIVACY-ENHANCED MESSAGE-----