-----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, HA2tKmdFK5VyChq0Q/heJar8X4YaV7XgLptl7HJiXxEqVWT/DZh/hTXnqmk7a9BU kx/IldYojoM224u86avz6g== 0001097715-01-500003.txt : 20010628 0001097715-01-500003.hdr.sgml : 20010628 ACCESSION NUMBER: 0001097715-01-500003 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010625 FILED AS OF DATE: 20010627 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SMITH MIDLAND CORP CENTRAL INDEX KEY: 0000924719 STANDARD INDUSTRIAL CLASSIFICATION: CONCRETE PRODUCTS, EXCEPT BLOCK & BRICK [3272] IRS NUMBER: 541727060 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-13752 FILM NUMBER: 1668339 BUSINESS ADDRESS: STREET 1: ROUTE 28 STREET 2: P O BOX 300 CITY: MIDLAND STATE: VA ZIP: 22728 BUSINESS PHONE: 5404393266 MAIL ADDRESS: STREET 1: P.O. BOX 300 STREET 2: P.O. BOX 300 CITY: MIDLAND STATE: VA ZIP: 22728 COMPANY DATA: COMPANY CONFORMED NAME: SOURLIS VIRGINIA K ESQ CENTRAL INDEX KEY: 0001097715 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: PO BOX 237 CITY: RED BANK STATE: NJ ZIP: 07701 MAIL ADDRESS: STREET 1: PO BOX 237 CITY: RED BANK STATE: NJ ZIP: 07701 3 1 fm3kassner.txt ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0104 Expires: 12-31-2001 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* FRED E. KASSNER (ESTATE OF) ________________________________________________________________________________ (Last) (First) (Middle) 69 SPRING STREET ________________________________________________________________________________ (Street) RAMSEY NEW JERSEY 07446 ________________________________________________________________________________ (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol SMITH MIDLAND CORPORATION (SMID) ________________________________________________________________________________ 5. Relationship of Reporting Person to Issuer (Check all applicable) [_] Director [X] 10% Owner [_] Officer (give title below) [_] Other (specify below) ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form Filed by 1 Reporting Person [_] Form Filed by More than 1 Reporting Person ====================================================================== Table I -- Non-Derivative Securities Beneficially Owned ====================================================================== 3. Ownership Form: 2. Amount of Securities Direct (D) or 4. Nature of Indirect 1. Title of Security Beneficially Owned Indirect (I) Beneficial Ownership (Inst. 4) Inst. 4) (Inst. 5) (Inst. 4) COMMON STOCK 589,172 D Explanation of Responses: (1) Includes 395,000 shares owned directly by H. T. Ardinger & Sons, Inc. and 60,000 shares owned by Horace T. Ardinger, Jr. Mr. Ardinger is the President of H. T. Ardinger & Sons, Inc., and may be deemed to beneficially own the shares of common stock owned by H. T. Ardinger & Sons, Inc. Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) SEC 1473 (3-99) 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 Exerc- tion of Derivative (I) Ownership Security (Inst. 4) cisable Date Title Shares Security (Inst. 5) (Inst. 5) Explanation of Responses: /s/MICHELLE KASSNER, CO-EXECUTOR, ESTATE OF FRED E. KASSNER June 25, 2001 - --------------------------------------------- ----------------------- **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. -----END PRIVACY-ENHANCED MESSAGE-----