-----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, R2opPe5jAUhgw8Z9teL5fSajZG81ghBohG+wnxXMoIU5JG+lUIjuXUZeJMDqlzrD 8OWfJGcOd4jOeps1ZpX4lg== 0001015870-98-000003.txt : 19980218 0001015870-98-000003.hdr.sgml : 19980218 ACCESSION NUMBER: 0001015870-98-000003 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980213 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: 5 SEC ACT: SEC FILE NUMBER: 000-06215 FILM NUMBER: 98538688 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: 5 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 5 1 FORM 5 - DECEMBER 31, 1997 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). ( ) Form 3 Holdings Reported ( ) Form 4 Transactions Reported 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 31, 1997 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 Reporting (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 | |Date |Code| | Beneficially |(D)or | | | | | | A/| | Owned at |Indir | | | | | Amount | D | Price | End of Year |ect(I)| | ___________________________________________________________________________________________________________________________________| Common Stock | | | | | |114,039 |D | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock | | | | | |4,114 |I |By 401(k) plan | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |4/9/97|J4 (| | | |1,800 |I |By wife (2) | | |1) | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |6/27/9|S4 |800 |D |14.13 |1,000 |I |By wife (2) | |7 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |6/27/9|S4 |1,000 |D |14.00 |0 |I |By wife (2) | |7 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |8/6/97|P4 |4,000 |A |15.00 |4,000 |I |By wife (2) | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock |12/29/|P4 |2,000 |A |14.50 |6,000 |I |By wife (2) | |97 | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ 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 |Date |Code| rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial | |cise Pr | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership | |ice 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 | | | Amount | |ble | | | |Year |(I)| | ___________________________________________________________________________________________________________________________________| Employee stock option (r| | | | | | | |Common Stock|64,000 | |64,000 |D | | ight to buy) | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) The reporting person's spouse owned 1,800 shares of common stock prior to date of marriage. (2) The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the beneficial owner of such securities for purposes of Section 16 or for any other purpose. DATE February 12., 1998 -----END PRIVACY-ENHANCED MESSAGE-----