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*
LEWIS KIM A SURVIVORS TRUST UTA 09 24 1991

(Last) (First) (Middle)
PO BOX 284

(Street)
PROSPECT OR 97536

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MEADOW VALLEY CORP [ (MVCO) ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
06/26/2003
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X 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
Common Stock, par value $0.001 06/26/2003 S 2,000 D $1.12 409,034 I(1)(2) by Trust
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
1. Name and Address of Reporting Person*
LEWIS KIM A SURVIVORS TRUST UTA 09 24 1991

(Last) (First) (Middle)
PO BOX 284

(Street)
PROSPECT OR 97536

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
MARSHALL LEWIS KIM

(Last) (First) (Middle)
KIM LEWIS MARSHALL
630 BUTTE FALLS HIGHWAY

(Street)
PROSPECT OR 97536

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Beneficial owner less than 10%
1. Name and Address of Reporting Person*
LEWIS C RICHARD GST EXEMPT MARTIAL SUB TRUST

(Last) (First) (Middle)
RICHARD C. LEWIS GST EXEMPT MARITAL SUB
630 BUTTE FALLS HIGHWAY

(Street)
PROSPECT OR 97536

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director 10% Owner
Officer (give title below) X Other (specify below)
Beneficial owner less than 10%
Explanation of Responses:
1. These securities are owned solely by the Kim A. Lewis Survivors Trust, u/t/a dated 9/24/1991 ("Survivors Trust"), of which Kim Lewis Marshall is Trustee. The Survivors Trust may be deemed to be a member of a "group" with Kim Lewis Marshall and the Marital Trust (referred to below) for purposes of Section 13(d) of the Exchange Act. The Trustee may be deemed to be a beneficial owner of the shares because members of her family are the beneficiaries of the Survivors Trust. The Trustee disclaims beneficial ownership of all of the shares owned by the Survivors Trust in excess of her pecuniary interest, if any, in said Trust. (Continued Below)
2. (Footnote 1 Continued) Does not include 66,666 shares owned solely by the Richard C. Lewis GST Exempt Marital Sub Trust, u/t/a dated 4/5/1994 ("Marital Trust"), of which Kim Lewis Marshall is Trustee. The Marital Trust may be deemed to be a member of a "group" with Kim Lewis Marshall and the Survivors Trust for purposes of Section 13(d) of the Exchange Act. The Trustee may be deemed to be a beneficial owner of the shares because members of her family are the beneficiaries of the Marital Trust. The Trustee disclaims beneficial ownership of all of the shares owned by the Marital Trust in excess of her pecuniary interest, if any, in said Trust.
/s/Kim Lewis Marshall, Individually 03/25/2004
** 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.
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