-----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, KhO8yhED949bGVwLNuxcGYlDbG9iwdRwJmu4nk3XEVt3rR6cpwB5iThMSVUMlnIH zMI8FWKJn7EmaUw0c0m/uQ== 0000893046-00-000020.txt : 20000207 0000893046-00-000020.hdr.sgml : 20000207 ACCESSION NUMBER: 0000893046-00-000020 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000204 FILED AS OF DATE: 20000204 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: RENT WAY INC CENTRAL INDEX KEY: 0000893046 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-EQUIPMENT RENTAL & LEASING, NEC [7359] IRS NUMBER: 251407782 STATE OF INCORPORATION: PA FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 3/A SEC ACT: SEC FILE NUMBER: 000-22026 FILM NUMBER: 524338 BUSINESS ADDRESS: STREET 1: ONE RENTWAY PLACE CITY: ERIE STATE: PA ZIP: 16505 BUSINESS PHONE: 8144555378 MAIL ADDRESS: STREET 1: 3230 WEST LAKE RD STREET 2: 3230 WEST LAKE RD CITY: ERIE STATE: PA ZIP: 16505 COMPANY DATA: COMPANY CONFORMED NAME: RENT WAY INC CENTRAL INDEX KEY: 0000893046 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-EQUIPMENT RENTAL & LEASING, NEC [7359] OFFICER IRS NUMBER: 251407782 STATE OF INCORPORATION: PA FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: ONE RENTWAY PLACE CITY: ERIE STATE: PA ZIP: 16505 BUSINESS PHONE: 8144555378 MAIL ADDRESS: STREET 1: 3230 WEST LAKE RD STREET 2: 3230 WEST LAKE RD CITY: ERIE STATE: PA ZIP: 16505 3/A 1 UNDERWOOD FORM 3 - AMENDED ------------------------------ OMB APPROVAL ------------------------------ OMB Number Expires: Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(f) of the Investment Company Act of 1940 ________________________________________________________________________________ 1. Name and Address of Reporting Person* Underwood Jeffrey K. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 5533 Townsend Warbler Drive - -------------------------------------------------------------------------------- (Street) Wake Forest NC 27587 - -------------------------------------------------------------------------------- (City) (State) (Zip) February 4, 2000 ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) ###-##-#### ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) Rent-Way, Inc. RWY ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Officer - Senior Vice President, Operations ________________________________________________________________________________ 5. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) Vice President, Operations ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) October 25, 1999 ________________________________________________________________________________ 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 Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) (Form 3-07/98) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Rent-Way, Inc. Com. Stk. (See Note) 02/05/03 Stock Option 20,000 22.00 (D) - ------------------------------------------------------------------------------------------------------------------------------------ (*Note: 10,000 shares are currently vested; 10,000 shares vest on 2/5/00) - ------------------------------------------------------------------------------------------------------------------------------------ Rent-Way, Inc. Com. Stk. (See Note) 02/08/04 Stock Option 15,000 27.875 (D) - ------------------------------------------------------------------------------------------------------------------------------------ (*Note: 4,999 shares vest on 11/1/00; 5,000 shares vest on 11/1/01; 5,001 shares vest on 11/1/02) - ------------------------------------------------------------------------------------------------------------------------------------ Rent-Way, Inc. Com. Stk. (See Note) 09/13/04 Stock Option 70,000 22.1875 (D) - ------------------------------------------------------------------------------------------------------------------------------------ (*Note: 23,333 shares vest on 9/13/2000; 23,333 shares vest on 9/13/2001; 23,334 shares vest on 9/13/2002) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: /s/ Jeffrey K. Underwood February 4, 2000 - --------------------------------------------- ----------------------- **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 provided is insufficient, see Instruction 6 for procedure. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----