-----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, L5Al07kDecKZDWHLIg8c83F29i1iaGpoFajZSQ6UWNM4k+47J7f7DCs2Hi1CgIjr jSGEjkYgDdHTbuWupteSrg== 0000891020-03-000062.txt : 20030114 0000891020-03-000062.hdr.sgml : 20030114 20030108123246 ACCESSION NUMBER: 0000891020-03-000062 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030106 FILED AS OF DATE: 20030108 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: BLODNICK MICHAEL J CENTRAL INDEX KEY: 0001207271 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 49 COMMONS LOOP CITY: KALISPELL STATE: MT ZIP: 59901 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GLACIER BANCORP INC CENTRAL INDEX KEY: 0000868671 STANDARD INDUSTRIAL CLASSIFICATION: STATE COMMERCIAL BANKS [6022] IRS NUMBER: 810519541 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-18911 FILM NUMBER: 03507441 BUSINESS ADDRESS: STREET 1: 49 COMMONS LOOP STREET 2: . CITY: KALISPELL STATE: MT ZIP: 59901 BUSINESS PHONE: 4067564200 MAIL ADDRESS: STREET 1: 49 COMMONS LOOP STREET 2: . CITY: KALISPELL STATE: MT ZIP: 59901 4 1 v86893mbe4.htm FORM 4 DATED JANUARY 6, 2003 Form 4
 

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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)
  Blodnick, Michael J.
  Glacier Bancorp, Inc. (GBCI)
 
 
475 Third Avenue EN

4. Statement for (Month/Day/Year) 5. If Amendment, Date of Original (Month/Day/Year)
    January 2003
 
  (Street) 6. Relationship of Reporting Person(s) to Issuer (Check All Applicable) 7. Individual or Joint/Group Filing
(Check Applicable Line)
  Kalispell, MT 59901
(City)                (State)           (Zip)
  x  Director o  10% Owner   x Form filed by One Reporting Person
    x  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)  
        President and Chief Executive Officer
     

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             1,282     I   Custodian

  Common Stock               319     I   Custodian

  Common Stock               10,397     I   Wife's IRA

  Common Stock   1-6-03     M   8,451   A 18.31     72,921     D   With Wife

  Common Stock               35,937     I   Wife

  Common Stock               10,110     I   Pension/Profit Sh

  Common Stock               819     I   Family Ptship

                   

                   

                   

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)

  Option   18.79          

  Option   13.63          

  Option   13.56          

  Option   17.50          

  Option   21.89          

             

             

             

             

             

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
                       

  1-27-01 1-27-04   Common Stock 7,262         7,262     D  

  1-26-02 1-26-05   Common Stock 2,915         2,915     D  

  1-31-03 1-31-06   Common Stock 2,825         2,825     D  

  11-20-03 11-20-06   Common Stock 5,000         5,000     D  

  1-30-04 1-30-07   Common Stock 2,650         2,650     D  

                 

                 

                 

                 

                 

Explanation of Responses:

/s/ Michael J. Blodnick   January 7, 2003

**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.
 

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