4 1 d4.txt FORM 4 +--------+ | FORM 4 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 [_] Check this box if no longer subject STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* Zucker, Jerry -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o Polymer Group, Inc. 4838 Jenkins Ave. -------------------------------------------------------------------------------- (Street) North Charleston, South Carolina 29405 -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol Polymer Group, Inc. (NYSE Trading Symbol "PGI" ----------------------------------- 3. I.R.S. or Social Security Number of Reporting Person (Voluntary) ---------------------------------------------------------------- 4. Statement for Month/Year August 2001 --------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) --------------------------------- 6. Relationship of Reporting Person to Issuer (Check all applicable) X Director X Officer X 10% Owner Other --- --- (give title below) --- ---(specify below) Chairman, CEO & President ---------------------------------------------------------------------------- 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 Acquired, Disposed of, or Beneficially Owned
------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of action action or Disposed of (D) Securities ship of In- Security Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 3) (Month/ (Instr. 8) Owned at Direct Bene- Day/ ----------------------------------------------- End of (D) or ficial Year) Month Indirect Owner- Code V Amount (A) or Price (Instr. 3 and 4) (I) ship (D) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 8/23/01 P 2,300 A $1.40 ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 8/23/01 P 22,500 A $1.35 3,540,729 D ------------------------------------------------------------------------------------------------------------------------------------ Common Stock n/a 10,890 I by children ------------------------------------------------------------------------------------------------------------------------------------ Common Stock n/a 7,080 I by wife ------------------------------------------------------------------------------------------------------------------------------------ Common Stock n/a 3,599,557 I See (1) ------------------------------------------------------------------------------------------------------------------------------------ Common Stock n/a 261,651 I See (2) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Table II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) Security --------------------------------------------------- Code V (A) (D) ----------------------------------------------------------------------------------------------------------------------------- N/A ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------------------------
------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative Form of In- Date ative Secur- of De- direct (Month/Day/ Secur- ities rivative Bene- Year) ity Bene- Secu- ficial (Instr. ficially rity Owner- -------------------------------------------- 5) Owned Direct ship Date Expira- Amount or at End (d) or (Instr. 4) Exer- tion Title Number of of Indirect cisable Date Shares Month (J) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) The InterTech Group, Inc. ("InterTech"), a Delaware corporation, is the direct beneficial owner of the shares of common stock reported. Mr. Zucker is the Chairman, Chief Executive Officer and President of InterTech. Mr. Zucker also owns greater than 50% of the voting stock of InterTech, and participates as a director in the exercise of investment control over securities held by InterTech. Mr. Zucker expressly disclaims beneficial ownership of the shares reported in Table I. The filing of this form shall not be deemed an admission that Mr. Zucker is, for purposes of Section 16 or otherwise, the beneficial owner of such securities. (2) FTG, Inc. ("FTG"), a Delaware corporation, is the direct beneficial owner of the shares of common stock reported. Mr. Zucker is the Chairman, Chief Executive Officer and President of FTG. Mr. Zucker also owns greater than 50% of the voting stock of FTG, and participates as a director in the exercise of investment control over securities held by FTG. Mr. Zucker expressly disclaims beneficial ownership of the shares reported in Table I. The filing of this form shall not be deemed an admission that Mr. Zucker is, for purposes of Section 16 or otherwise, the beneficial owner of such securities. /s/ Jerry Zucker 08/30/01 ------------------------------- ----------------- **Signature of Reporting Person Date Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. * If this 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 provided is insufficient, see Instruction 6 for procedure. 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 currently valid OMB Number. Page 2 SEC 1474 (8-92)