-----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, STbl+RthlSkFPFbQGhmpNdnaGBoRjGMW2LDsS6NItR2Vs59PqVbMzgkp271T9Zwe oBzzD61ZCSIXMTERz+FA3Q== 0000897069-04-000577.txt : 20040311 0000897069-04-000577.hdr.sgml : 20040311 20040311184340 ACCESSION NUMBER: 0000897069-04-000577 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040309 FILED AS OF DATE: 20040311 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CARVER ROY J CENTRAL INDEX KEY: 0001025076 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-07007 FILM NUMBER: 04663915 BUSINESS ADDRESS: STREET 1: 8989 NORTH DEERWOOD DR CITY: MILWAUKEE STATE: WI ZIP: 53223 BUSINESS PHONE: 4143779400 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 4 1 dkm133_ex.xml X0201 4 2004-03-09 0 0000009534 BANDAG INC BDG, BDGA 0001025076 CARVER ROY J BANDAG, INCORPORATED 2905 NORTH HIGHWAY 61 MUSCATINE IA 52761-5886 1 0 1 0 Common Stock, $1.00 Par Value 6991.5 I By Carver Management Company LLC Common Stock, $1.00 Par Value 867234 I By Carver Partners LP Class A Common Stock, $1.00 Par Value 2004-03-09 4 A 0 332 0 A 162332 D Class A Common Stock, $1.00 Par Value 8944 I By Carver Management Company LLC Class A Common Stock, $1.00 Par Value 1109390.7 I By Carver Partners LP Class B Common Stock, $1.00 Par Value 0 Common Stock 400732 400732 D Stock Option (Right to Buy) 21.0313 2000-05-02 2010-05-02 Class A Common Stock 1700 1700 D Stock Option (Right to Buy) 24.35 2001-03-13 2011-03-13 Class A Common Stock 1825 1825 D Stock Option (Right to Buy) 32.53 2002-03-12 2012-03-12 Class A Common Stock 1800 1800 D Stock Option (Right to Buy) 26.6550 2003-03-11 2013-03-11 Class A Common Stock 3400 3400 D Stock Option (Right to Buy) 47.47 2004-03-09 4 A 0 1220 0 A 2004-03-09 2014-03-09 Class A Common Stock 1220 1220 D Pursuant to Rule 16(a)-1(a)(2), Carver Management Company LLC ("Carver LLC") disclaims beneficial ownership of all of the securities held by Carver Partners LP ("Carver LP") other than 13,983 shares of the Common Stock (in which Roy J. Carver, Jr. has a 50% interest) and 17,888 shares of the Class A Common Stock (in which Roy J. Carver, Jr. has a 50% interest). Pursuant to Rule 16(a)-1(a)(2), Roy J. Carver, Jr. disclaims beneficial ownership of all of the securities held by Carver LP other than those he holds indirectly through Carver LLC and 867,234 shares of the Common Stock and 1,109,390.7 shares of the Class A Common Stock. Class B Common Stock is convertible on a one-for-one basis into the Common Stock at the discretion of the holder thereof. Roy J. Carver, Jr. participates in the Bandag, Incorporated Stock Award Plan ("Stock Award Plan"). Column 5 of Table I includes 332 shares of the Class A Common Stock held by Mr. Carver 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. Carver. /s/ Roy J. Carver, Jr. 2004-03-10 -----END PRIVACY-ENHANCED MESSAGE-----