-----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, JQS0nUP8wO1TiF07zhMTs9xBhcNvJ4doPI3JcYDBC0nyN+QZmEpHh4awtazovP3q MNAHx+P+QlLXS8egiqATOw== 0000897069-04-000259.txt : 20040205 0000897069-04-000259.hdr.sgml : 20040205 20040205123952 ACCESSION NUMBER: 0000897069-04-000259 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031231 FILED AS OF DATE: 20040205 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DERBY NATHANIEL L II CENTRAL INDEX KEY: 0001207251 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07007 FILM NUMBER: 04569301 MAIL ADDRESS: STREET 1: BANDAG INC STREET 2: 2905 N HWY 61 CITY: MUSCATINE STATE: IA ZIP: 52761 ISSUER: 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 BUSINESS ADDRESS: STREET 1: 2905 NORTH HIGHWAY 61 STREET 2: BANDAG HEADQUARTERS CITY: MUSCATINE STATE: IA ZIP: 52761-5886 BUSINESS PHONE: 5632621400 MAIL ADDRESS: STREET 1: 2905 N HIGHWAY 61 STREET 2: BANDAG HEADQUARTERS CITY: MUSCATINE STATE: IA ZIP: 52761-5886 5 1 cmw411_ex.xml X0201 5 2003-12-31 0 0 0 0000009534 BANDAG INC BDG, BDGA 0001207251 DERBY NATHANIEL L II BANDAG, INCORPORATED 2905 NORTH HIGHWAY 61 MUSCATINE IA 52761-5886 0 1 0 0 VP, Manufacturing Design Common Stock, $1.00 Par Value 5400 D Class A Common Stock, $1.00 Par Value 17570 D Stock Fund Unit 0 Common Stock 231.7970 231.7970 I By Profit Sharing Plan Stock Fund Unit 0 Class A Common Stock 266.8310 266.8310 I By Profit Sharing Plan Employee Stock Option (Right to Buy) 33.875 2009-02-08 Class A Common Stock 6000 6000 D Employee Stock Option (Right to Buy) 21.0938 2010-03-07 Class A Common Stock 12600 12600 D Employee Stock Option (Right to Buy) 24.35 2011-03-13 Class A Common Stock 13300 13300 D Employee Stock Option (Right to Buy) 32.53 2012-03-12 Class A Common Stock 12100 12100 D Employee Stock Option (Right to Buy) 27.6750 2013-02-25 Class A Common Stock 16500 16500 D Nathaniel L. Derby II participates in the Bandag, Incorporated Restricted Stock Grant Plan ("Plan"). Column 5 of Table I includes 770 shares of Common Stock and 770 shares of Class A Common Stock held by Mr. Derby under the Plan. The shares are restricted for 7 years when granted and are held by a Trustee for the benefit of Mr. Derby. Nathaniel L. Derby II participates in the Bandag, Incorporated Stock Award Plan ("Stock Award Plan"). Column 5 of table I includes 7,510 shares of Class A Common Stock held by Mr. Derby under the Stock Award Plan. The shares are restricted for 3 years when granted and are held by a Trustee for the benefit of Mr. Derby. 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. 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 December 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. Options for 6,000 shares of Class A Common Stock with 20% vesting (1,200 shares) on each of February 8, 2000, 2001, 2002, 2003, 2004. Options for 12,600 shares of Class A Common Stock with 20% vesting (2,520 shares) on each of March 7, 2001, 2002, 2003, 2004, 2005. Options for 13,300 shares of Class A Common Stock with 20% vesting (2,660 shares) on each of March 13, 2002, 2003, 2004, 2005, 2006. Options for 12,100 shares of Class A Common Stock with 25% vesting (3,025 shares) on each of March 12, 2003, 2004, 2005, 2006. Options for 16,500 shares of Class A Common Stock with 25% vesting (4,125 shares) on each of February 25, 2004, 2005, 2006, 2007. Nathaniel L. Derby, II 2004-02-02 -----END PRIVACY-ENHANCED MESSAGE-----