-----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, LfsUGUS50wtDYhhdAFyRlmwsT3ywMvP2kbDuqvNsTzAwF/PP20+iU/9xRDbmWBeq Qt5jklbgiC+RRkSXc5Ak1A== 0000950134-03-004501.txt : 20030325 0000950134-03-004501.hdr.sgml : 20030325 20030325171904 ACCESSION NUMBER: 0000950134-03-004501 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030324 FILED AS OF DATE: 20030325 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: SCOTT HOMER A JR CENTRAL INDEX KEY: 0001195494 RELATIONSHIP: DIRECTOR FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: FIRST INTERSTATE BANK STREET 2: PO BOX 2007 CITY: SHERIDAN STATE: WY ZIP: 82801 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FIRST INTERSTATE BANCSYSTEM INC CENTRAL INDEX KEY: 0000860413 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 810331430 STATE OF INCORPORATION: MT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-49733 FILM NUMBER: 03616343 BUSINESS ADDRESS: STREET 1: P O BOX 30918 STREET 2: 401 NO 31ST STREET CITY: BILLINGS STATE: MT ZIP: 59116-0918 BUSINESS PHONE: 4062555300 FORMER COMPANY: FORMER CONFORMED NAME: FIRST INTERSTATE BANCSYSTEM OF MONTANA INC DATE OF NAME CHANGE: 19930615 4 1 c75700ae4.htm FORM 4 e4
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, DC 20549

FORM 4

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

o 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*
(Last, First, Middle)
2. Issuer Name and Ticker or
Trading Symbol
3. I.R.S. Identification Number of Reporting
Person, if an entity
(Voluntary)
  Scott, Jr., Homer A.
  First Interstate BancSystem, Inc. (no ticker or trading symbol)
 
 
4 South Main

4. Statement for (Month/Day/Year) 5. If Amendment, Date of Original (Month/Day/Year)
    March 24, 2003
 
  (Street) 6. Relationship of Reporting Person(s) to Issuer (Check All Applicable) 7. Individual or Joint/Group Filing
(Check Applicable Line)
  Sheridan, WY 82801
(City)                (State)           (Zip)
  x  Director x  10% Owner   x Form filed by One Reporting Person
    o  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)  
        Chairman of the Board
     

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).
 

 


 


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
Transactions(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             710,323     D   N/A

  Common Stock               8,534     I   By 401(K) Plan

  Common Stock               10,208     I   By Spouse

  Common Stock   3/24/03     D   526   D $46.00     42,780     I   Beneficiary of Charitable Remainder Unitrust

  Common Stock   3/24/03     D   142   D $46.00     10,970     I   Beneficiary of Charitable Remainder Unitrust - 2002

                     

                     

                   

                   

                   

Page 2


 


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)

                      Code V   (A) (D)

  Stock Option   42.00          

  Stock Option   42.00          

  Stock Option(1)(2)   44.00          

  Stock Option(1)   44.00          

             

             

             

             

             

             

Page 3


 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date

(Month/Day/Year)
7. Title and Amount
of Underlying Securities

(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 of
Derivative Security:
Direct (D) or Indirect (I)

(Instr. 4)
11. Nature of
Indirect
Beneficial
Ownership

(Instr. 4)

  Date
Exercisable
Expiration
Date
  Title Amount or
Number of
Shares
                       

  2/19/02 3/15/09   Common Stock 110         110     D  

  2/19/02 5/31/10   Common Stock 834         834     D  

  5/17/02 5/16/12   Common Stock 609         609     D  

  7/24/02 8/15/11   Common Stock 746         746     D  

                 

                 

                 

                 

                 

                 

Explanation of Responses:

(1) Vests over 3 years - 25% immediately and 25% each anniversary date.

(2) Stock options granted at the discretion of the Compensation Committee of the Board of Directors for no consideration.

/s/ TERRILL R. MOORE   3/24/03

**Signature of Attorney in Fact for 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.
 

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