SEC Form 4
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
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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*
TRAGER SCOTT

(Last) (First) (Middle)
601 WEST MARKET STREET

(Street)
LOUISVILLE KY 40202

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
REPUBLIC BANCORP INC /KY/ [ RBCAA ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Vice Chairman
3. Date of Earliest Transaction (Month/Day/Year)
10/28/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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 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 10/28/2004 M 5,250(6) A $12.38 127,441 D
Class A Common Stock 10/28/2004 F 2,220 D $29.27 125,221 D
Class A Common Stock 1,652.566 I By Jaytee Properties Limited Partnership(1)
Class A Common Stock 23,922(2) I By 401(k) Plan
Class A Common Stock 15,810.019 I By Teebank Family Limtied Partnership(3)
Class A Common Stock 1,544.011(5) I By ESOP
Class A Common Stock 17,751 I By Trager Family Irrevocable Trust(4)
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(6) $12.38 10/28/2004 M 5,250(6) 08/01/2004 07/31/2005 Class A Common Stock 5,250(6) $12.38 0 D
Explanation of Responses:
1. Jaytee Properties Limited Partnership is a family limited partnership of which the reporting person is a limited partner.
2. Includes 100 shares of Class A Common Stock acquired under the Issuer's 401(k) plan, based upon information provided by the plan trustee.
3. Teebank Family Limited Partnership is a family limited partnership of which the reporting person is a limited partner.
4. Trager Family Irrevocable Trust is a family trust of which the reporting person is a co-trustee and a beneficiary.
5. On March 18, 2004, Issuer declared a stock dividend, payable to all holders of record of common stock of March 30, 2004, of .05 shares of common stock for each share of common stock outstanding.
6. 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 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/ Scott Trager 11/01/2004
** 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.