FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
|
|||||||||||||||
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*
(Street)
|
2. Issuer Name and Ticker or Trading Symbol
REPUBLIC BANCORP INC /KY/ [ RBCAA ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
|
||||||||||||||||||||||||
3. Date of Earliest Transaction
(Month/Day/Year) 07/27/2004 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
|
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 Transaction(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 | ||||||
Class A Common Stock | 168,127.472(9) | I | By Jaytee Properties Limited Partnership(1) | |||||||
Class A Common Stock | 1,608,467.475(9) | I | Teebank Family Limited Partnership(2) | |||||||
Class A Common Stock | 6,460(9) | I | By Spouse(3) | |||||||
Class A Common Stock | 07/27/2004 | M | 5,250(10) | A | $12.38(10) | 73,500(9) | D | |||
Class A Common Stock | 6,543(9) | I | By 401(k) Plan(7) | |||||||
Class A Common Stock | 187,795.59 | I | By ESOP(8) |
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) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Employee Stock Option Right to Buy | $12.38(10) | 07/27/2004 | M | 5,250(10) | 08/01/2003 | 07/31/2004 | Class A Common Stock | 5,250(10) | $12.38 | 0 | D | ||||
Class B Common Stock | (4) | (5) | (6) | Class A Common Stock | (4) | 36,602.621(9) | I | By Jaytee Properties Limited Partnership(1) | |||||||
Class B Common Stock | (4) | (5) | (6) | Class A Common Stock | (4) | 14,700(9) | D | ||||||||
Class B Common Stock | (4) | (5) | (6) | Class A Common Stock | (4) | 1,050(9) | I | By 401(k) Plan | |||||||
Class B Common Stock | (4) | (5) | (6) | Class A Common Stock | (4) | 208,151.08(9) | I | By Teebank Family Limited Partnership(2) |
Explanation of Responses: |
1. Jaytee Properties Limited Partnership is a family limited partnership of which the reporting person is a general partner and a limited partner and of which trusts for the benefit of, among others, the reporting person, the reporting person's spouse, and the reporting person's two minor children are limited partners. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
2. Teebank Family Limited Partnership is a family limited partnership of which the reporting person is a general partner and a limited partner and of which trusts for the benefit of, among others, the reporting person, the reporting person's spouse, and the reporting person's two minor children are limited partners. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
3. The reporting person disclaims beneficial ownership of these securities, and the report shall not be deemed an admission that the reporting person is the beneficial owner of such securities. |
4. Conversion is on a share for share basis. |
5. Immediate. |
6. None |
7. Includes 1,232 shares of Class A Common Stock acquired under the Issuer's 401(k) plan, based upon information provided by the plan trustee. |
8. Includes 184,978.4229 unallocated shares of Class A Common Stock held by the Issuer's ESOP, of which the reporting person serves as a member of the Administrative Committee, and 1,346.6796 shares of Class A Common Stock allocated to the reporting person's father. 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. Also includes 1,470.4876 shares of Class A Common Stock allocated to the reporting person under the ESOP. |
9. On March 18, 2004, Issuer declared a stock dividend, payable to all holders of record of common stock on March 30, 2004, of .05 shares of common stock for each share of common stock outstanding. |
10. This option was previously reported as an option for 5,000 shares of common stock at an exercise price of $13.00 per share, but was adjusted to reflect the stock dividend declared by Issuer on March 18, 2004. As a result of the stock dividend, pursuant to anti-dilution provisions of Issuer's employee stock option plan, the option entitled the reporting person to receive, upon exercise, a total of 5,250 shares of Class A Common Stock at an exercise price of $12.38 per share. |
/s/ Steven E. Trager | 07/29/2004 | |
** Signature of Reporting Person | Date | |
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). | ||
** 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. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |