-----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, TOGRfeonzT54TdCm9DtqIUr9iPx4RqRtybCVm5kS2Xtz4TFBNRuCBCRTxDB8hi/L DdlZUASdn8k8w8BRu2rQrw== 0001015870-97-000002.txt : 19970110 0001015870-97-000002.hdr.sgml : 19970110 ACCESSION NUMBER: 0001015870-97-000002 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970109 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: REPUBLIC AUTOMOTIVE PARTS INC CENTRAL INDEX KEY: 0000083194 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-MOTOR VEHICLE SUPPLIES & NEW PARTS [5013] IRS NUMBER: 381455545 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-06215 FILM NUMBER: 97503396 BUSINESS ADDRESS: STREET 1: 500 WILSON PIKE CIRCLE STE 115 CITY: BRENTWOOD STATE: TN ZIP: 37027 BUSINESS PHONE: 6153732050 MAIL ADDRESS: STREET 1: P.O. BOX 2088 CITY: BRENTWOOD STATE: TN ZIP: 37024 FORMER COMPANY: FORMER CONFORMED NAME: REPUBLIC GEAR INDUSTRIES INC DATE OF NAME CHANGE: 19720825 COMPANY DATA: COMPANY CONFORMED NAME: THOMPSON KEITH M CENTRAL INDEX KEY: 0001015870 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: P O BOX 2088 CITY: BRENTWOOD STATE: TN ZIP: 37024-2088 BUSINESS PHONE: 6153732050 MAIL ADDRESS: STREET 1: P O BOX 2088 CITY: BRENTWOOD STATE: TN ZIP: 37024-2088 4 1 FORM 4 - DECEMBER 1996 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person Thompson, Keith M. 64 Wyn Oak Nashville, TN 37205 USA 2. Issuer Name and Ticker or Trading Symbol Republic Automotive Parts, Inc. RAUT 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year December 1996 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Chief Executive Officer 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 | ___________________________________________________________________________________________________________________________________| 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | | Transaction | or Disposed of (D) | Securities |ect | Beneficial Ownership | | | | | Beneficially |(D)or | | | | | | | A/| | Owned at |Indir | | | Date |Code|V| Amount | D | Price | End of Month |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock | | | | | | |4,228 (1) |I |401(k) Plan | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | | |114,039 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securitites Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con- |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of| Security |version |Transaction | rivative Secu |cisable and| of Underlying |of Deri|of Deriva |Dir|Indirect | |or Exer | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |Price of| | | posed of(D) |Day/Year) | |rity |Benefi |or | | |Deriva- | | | |Date |Expir| | |ficially |Ind| | |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| | |Secu- | | | | | D |cisa-|Date | of Shares | |End of |ct | | |rity |Date |Code|V| Amount | |ble | | | |Month |(I)| | ___________________________________________________________________________________________________________________________________| Employee Stock Option |$16.00 |12/12|A |V|9,000 |A |(2) |12/12|Common Stock|9,000 | |54,000 |D | | (Right to Buy) | |/96 | | | | | |/01 | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) Between July 1, 1996 and September 30, 1996, the reporting person acquired 73 shares of Republic Automotive Parts, Inc. common stock under the Republic Automotive Parts, Inc. Savings Plan. (2) The option vests in 5 equal annual installments beginning on December 12, 1996. SIGNATURE OF REPORTING PERSON Keith M. Thompson DATE January 9, 1997 -----END PRIVACY-ENHANCED MESSAGE-----