-----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, R/2zI6kEjkd8jYuVTluv3McjLUvLBWBTu2MmaLPaGbt73CLsELN6okXafDIz9v1I to0UdcNz7qUA+vMqrQ65Eg== 0000897069-03-000263.txt : 20030227 0000897069-03-000263.hdr.sgml : 20030227 20030227170445 ACCESSION NUMBER: 0000897069-03-000263 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20030225 FILED AS OF DATE: 20030227 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: SISLER ANDREW M CENTRAL INDEX KEY: 0001207261 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: BANDAG INC STREET 2: 2905 N HWY 61 CITY: MUSCATINE STATE: IA ZIP: 52761 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BANDAG INC CENTRAL INDEX KEY: 0000009534 STANDARD INDUSTRIAL CLASSIFICATION: TIRES AND INNER TUBES [3011] IRS NUMBER: 420802143 STATE OF INCORPORATION: IA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07007 FILM NUMBER: 03583963 BUSINESS ADDRESS: STREET 1: 2905 NORTH HIGHWAY 61 STREET 2: BANDAG HEADQUARTERS CITY: MUSCATINE STATE: IA ZIP: 52761-5886 BUSINESS PHONE: 3192621400 MAIL ADDRESS: STREET 1: 2905 N HIGHWAY 61 STREET 2: BANDAG HEADQUARTERS CITY: MUSCATINE STATE: IA ZIP: 52761-5886 4 1 sdc337.txt FORM 4 - BANDAG - SISLER ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0287 Expires: January 31, 2005 Estimated average burden hours per response ....... 0.5 ------------------------------ UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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(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* Sisler, Andrew M. - -------------------------------------------------------------------------------- (Last) (First) (Middle) Bandag, Incorporated 2905 North Highway 61 - -------------------------------------------------------------------------------- (Street) Muscatine, IA 52761-5886 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Bandag, Incorporated (BDG and BDGA) ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Statement for Month/Day/Year February 25, 2003 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Day/Year) ================================================================================ 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [_] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) Vice President, North American Franchise Sales ________________________________________________________________________________ 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 ====================================================================================================================================
5. 6. 2A. 4. Amount of Owner- 2. Deemed Securities Acquired (A) or Securities ship Trans- Execution 3. Disposed of (D) Beneficially Form: 7. action Date, if Transaction (Instr. 3, 4 and 5) Owned Follow- Direct Nature of Date any Code --------------------------- ing Reported (D) or Indirect 1. (Month/ (Month/ (Instr. 8) (A) Transaction(s) Indirect Beneficial Title of Security Day/ Day/ ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) Year) Year) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ (1)(2) Common Stock, $1.00 Par Value 500.3279 D - ------------------------------------------------------------------------------------------------------------------------------------ Class A Common Stock, (1)(2) $1.00 Par Value 473.7662 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== 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). Persons who respond to the collection of information contained in this form are not required to respond (Over) unless the form displays a currently valid OMB control number. SEC 1474 (9-02)
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ====================================================================================================================================
10. 9. Owner- Number ship of Deriv- Form 2. 5. ative of Conver- Number of 7. Secur- Deriv- 11. sion Derivative Title and Amount ities ative Nature or 3A. Securities 6. of Underlying 8. Benefi- Secur- of Exer- Deemed 4. Acquired Date Securities Price cially ity: In- cise 3. Execu- Trans- (A) or Exercisable and (Instr. 3 and 4) of Owned Direct direct Price Trans- tion action Disposed Expiration Date ---------------- Deriv- Following (D) or Bene- 1. of action Date, Code of(D) (Month/Day/Year) Amount ative Reported In- ficial Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- Trans- direct Owner- Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity action(s) (I) ship Security Secur- Day/ Day/ ------ ---------- Exer- tion of (Instr (Instr (Instr (Instr (Instr. 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ By Profit Stock Common (4) (4) Sharing Fund Unit (3) (3) Stock 124.8970 124.8970 I Plan - ------------------------------------------------------------------------------------------------------------------------------------ Class A By Profit Stock Common (4) (4) Sharing Fund Unit (3) (3) Stock 147.2570 147.2570 I Plan - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option Class A (Right Common to Buy) 21.09375 (5) 3/07/10 Stock 10,400 10,400 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option Class A (Right Common to Buy) 24.35 (6) 3/13/11 Stock 7,400 7,400 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option Class A (Right Common to Buy) 32.53 (7) 3/12/12 Stock 8,600 8,600 D - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option Class A (Right Common to Buy) 27.6750 2/25/03 A 11,700 (8) 2/25/13 Stock 11,700 11,700 D ==================================================================================================================================== Explanation of Responses: (1) Column 5 of Table I includes shares of Common Stock and shares of Class A Common Stock acquired through automatic reinvestment of dividends under the Bandag, Incorporated Dividend Reinvestment and Optional Cash Purchase Plan ("DRP") . (2) Andrew M. Sisler participates in the Bandag, Incorporated Restricted Stock Grant Plan ("Plan"). Column 5 of Table I includes 385 shares of Common Stock and 385 shares of Class A Common Stock held by Mr. Sisler under the Plan. The shares are restricted for 7 years when granted and are held by a Trustee for the benefit of Mr. Sisler. (3) Represents stock fund units under the Bandag Salaried Profit Sharing, Retirement and Savings Plan ("Profit Sharing Plan"). Distributions will be made upon the earliest to occur of termination of employment, death or retirement, subject to limited exceptions. (4) The number of underlying securities is based on the number of stock fund units, the value of these units and the Company's Common and Class A Common Stock market values as of January 31, 2003. The actual number of shares issuable upon the distribution date is not determinable since the stock fund is a unitized account consisting of Company stock and other investments. (5) Options for 10,400 shares of Class A Common Stock with 20% vesting (2,080 shares) on each of March 7, 2001, 2002, 2003, 2004, 2005. (6) Options for 7,400 shares of Class A Common Stock with 20% vesting (1,480 shares) on each of March 13, 2002, 2003, 2004, 2005, 2006. (7) Options for 8,600 shares of Class A Common Stock with 25% vesting (2,150 shares) on each of March 12, 2003, 2004, 2005, 2006. (8) Options for 11,700 shares of Class A Common Stock with 25% vesting (2,925 shares) on each of February 25, 2004, 2005, 2006, 2007. ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Andrew M. Sisler 2/25/03 ------------------------------------- ---------- See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ** Signature of Reporting Person Date Andrew M. Sisler Note: File three copies of this Form, one of which must be manually signed. If space 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
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