-----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, KFc9QZCrfwy/MfH/rHEHdICMspNl9sI16N18SonHzqWqs24lBfkiDFfen0OSgHhg TzJrI4OfG5V0M27xPOpBKw== /in/edgar/work/0001013816-00-000048/0001013816-00-000048.txt : 20001019 0001013816-00-000048.hdr.sgml : 20001019 ACCESSION NUMBER: 0001013816-00-000048 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001009 FILED AS OF DATE: 20001018 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SOURCE MEDIA INC CENTRAL INDEX KEY: 0000900029 STANDARD INDUSTRIAL CLASSIFICATION: [4822 ] IRS NUMBER: 133700438 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-21894 FILM NUMBER: 742171 BUSINESS ADDRESS: STREET 1: 5400 LBJ FREEWAY STE 680 CITY: DALLAS STATE: TX ZIP: 75240 BUSINESS PHONE: 9727015400 MAIL ADDRESS: STREET 1: 5400 LBJ FREEWAY STE 680 CITY: DALLAS STATE: TX ZIP: 75240 FORMER COMPANY: FORMER CONFORMED NAME: HB COMMUNICATIONS ACQUISITION CORP DATE OF NAME CHANGE: 19950703 COMPANY DATA: COMPANY CONFORMED NAME: HOWORT PHILIP CENTRAL INDEX KEY: 0001126416 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: SOURCE MEDIA INC STREET 2: 5400 LBJ FRWY STE 680 CITY: DALLAS STATE: TX ZIP: 75240 BUSINESS PHONE: 9727015400 MAIL ADDRESS: STREET 1: SOURCE MEDIA INC STREET 2: 5400 LBJ FRWY STE 680 CITY: DALLAS STATE: TX ZIP: 75240 3 1 0001.txt FORM 3 FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 (Print or Type Responses) ================================================================================ 1. Name and Address of Reporting Person Howort Philip - -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Source Media, Inc., 5400 LBJ Freeway, Suite 680 - -------------------------------------------------------------------------------- (Street) Dallas TX 75240 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) 10/09/2000 ================================================================================ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ================================================================================ 4. Issuer Name and Ticker or Trading Symbol Source Media, Inc. (SRCM) ================================================================================ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [ X ] Officer (give title below) [ ] Other (specify below) Senior Vice President ================================================================================ 6. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 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 ================================================================================ - ------------------------------- ---------------------------- ---------------------------- ---------------------------- 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect 1. Title of Security Beneficially Owned Direct (D) or Beneficial (Instr. 4) (Instr. 4) Indirect (I) (Instr. 5) Ownership (Instr. 5) - ------------------------------- ---------------------------- ---------------------------- ---------------------------- Common Stock, par value $0.001 100 D - ------------------------------- ---------------------------- ---------------------------- ---------------------------- - ------------------------------- ---------------------------- ---------------------------- ---------------------------- - ------------------------------- ---------------------------- ---------------------------- ---------------------------- - ------------------------------- ---------------------------- ---------------------------- ---------------------------- - ------------------------------- ---------------------------- ---------------------------- ---------------------------- - ------------------------------- ---------------------------- ---------------------------- ----------------------------
* 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 5(b)(v) Form 3 (continued)
TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ----------------- ------------------------ ------------------------------ ------------------ ---------------- ------------------- 5. Ownership Form of Derivative 6. Nature of 1. Title of 2. Date 3. Title and Amount of 4. Conversion or Security: Indirect Derivative Exercisable and Securities Underlying Exercise Price Direct (D) Beneficial Security Expiration Date Derivative Security of Derivation Indirect (I) Ownership (Instr. 4) (Month/Day/ Year) (Instr. 4) Security (Instr. 5) (Instr. 5) - ----------------- ------------------------ ------------------------------ ------------------ ---------------- ------------------- Date Expiration Title Amount or Exercisable Date Number of Shares - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- Employee Stock Option (Right to Buy) (1) 10/09/2010 Common Stock 150,000 $4.625 D - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------ ----------- -------------- --------------- ------------------ ---------------- ------------------- - ----------------- ------------------------ -------------- --------------- ------------------ ---------------- -------------------
Explanation of Responses: (1) The option vests in four equal annual installments beginning on October 9, 2001. By: /s/ Philip Howort 10/18/2000 --------------------------------------------- ------------------ **Signature of Reporting Person Date Philip Howort ** 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 procedures. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a current valid OMB Number. Page 2 -----END PRIVACY-ENHANCED MESSAGE-----