OMB APPROVAL OMB Number: 3235-0101 Expires: August 31, 2003 Estimated average burden hours per response .... 2.0 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 144 NOTICE OF PROPOSED SALE OF SECURITIES PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933 |
SEC USE ONLY DOCUMENT SEQUENCE NO. CUSIP NUMBER WORK LOCATION |
ATTENTION: |
Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute sale or executing a sale directly with a market maker. |
1 (a) NAME OF ISSUER (Please type or print) | (b) IRS IDENT. NO. | (c) S.E.C. FILE NO. | ||
Carriage Services Inc. |
76-0423828 |
1016281 |
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1 (d) ADDRESS OF ISSUER | STREET | CITY | STATE | ZIP CODE | (e) TELEPHONE NO. 713-332-8400 |
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1900 St. James, 4th Floor | Houston, | Texas | 77056 | AREA CODE | NUMBER | |||||||
2 (a) NAME OF PERSON FOR WHOSE ACCOUNT THE SECURITIES ARE TO BE SOLD | (b) IRS IDENT. NO. | (c) RELATIONSHIP TO ISSUER | (d) ADDRESS STREET | CITY | STATE | ZIP CODE | ||||||
Mark L. Groeneman | Officer- Sr. VP | 3906 Valley Green Court | Houston, | Texas | 77059 | |||||||
INSTRUCTION: The person filing this notice should contact the issuer to obtain the I.R.S. Identification Number and the S.E.C. File Number.
3 (a) | (b) | SEC USE ONLY |
(c) | (d) | (e) | (f) | (g) | |||||||
Title of the Class of Securities To Be Sold | Name and Address of Each Broker Through Whom the Securities are to be Offered or Each Market Maker who is Acquiring the Securities | Broker-Dealer File Number | Number of Shares or Other Units To Be Sold | Aggregate Market Value | Number of Shares or Other Units Outstanding | Approximate Date of Sale | Name of Each Securities Exchange | |||||||
(See instr. 3(c)) | (See instr. 3(d)) | (See instr. 3(e)) | (See instr. 3(f)) (MO. DAY YR.) |
(See instr. 3(g)) | ||||||||||
Common Stock |
Ameritrade 4211 South 102nd St. Omaha, NE 68127 |
15000 |
72000 |
17587329 |
02/25/2004 |
NYSE |
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Common Stock |
Ameritrade 4211 South 102nd St. Omaha, NE 68127 |
50000 |
240000 |
17587329 |
05/29/2004 |
NYSE |
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INSTRUCTIONS: | ||||||||||
1. | (a) | Name of issuer | 3. | (a) | Title of the class of securities to be sold | |||||
(b) | Issuer's I.R.S. Identification Number | (b) | Name and address of each broker through whom the securities | |||||||
(c) | Issuer's S.E.C. file number, if any | are intended to be sold | ||||||||
(d) | Issuer's address, including zip code | (c) | Number of shares or other units to be sold (if debt securities, | |||||||
(e) | Issuer's telephone number, including area code | give the aggregate face amount) | ||||||||
(d) | Aggregate market value of the securities to be sold as of a specified | |||||||||
2. | (a) | Name of person for whose account the securities | date within 10 days prior to the filing of this notice | |||||||
are to be sold | (e) | Number of shares or other units of the class outstanding, | ||||||||
(b) | Such person's I.R.S. identification number, | or if debt securities the face amount thereof outstanding, as shown | ||||||||
if such person is an entity | by the most recent report or statement published by the issuer | |||||||||
(c) | Such person's relationship to the issuer (e.g., officer, | (f) | Approximate date on which the securities are to be sold | |||||||
director, 10% stockholder, or member of immediate | (g) | Name of each securities exchange, if any, on which the securities | ||||||||
family of any of the foregoing) | are intended to be sold | |||||||||
(d) | Such person's address, including zip code |
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 control number.
SEC 1174 (7-97)
TABLE I SECURITIES TO BE SOLD
Furnish the following information with respect to the acquisition of the securities to be sold
and with respect to the payment of all or any part of the purchase price or other consideration therefor:
Title of the Class | Date you Acquired | Nature of Acquisition Transaction | Name of Person from Whom Acquired (If gift, also give date donor acquired) |
Amount of Securities Acquired | Date of Payment | Nature of Payment | ||||||
Common Stock |
12/22/2000 |
Company Award |
Carriage Services Inc. |
35000 |
|
|
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Common Stock |
02/11/2002 |
Company Award |
Carriage Services, Inc. |
15000 |
|
|
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INSTRUCTIONS: | 1. | If the securities were purchased and full payment therefor was not made in cash at the time of purchase, explain in the table or in a note thereto the nature of the consideration given. If the consideration consisted of any note or other obligation, or if payment was made in installments describe the arrangement and state when the note or other obligation was discharged in full or the last installment paid. | 2. | If within two years after the acquisition of the securities the person for whose account they are to be sold had any short positions, put or other option to dispose of securities referred to in paragraph (d)(3) of Rule
144, furnish full information with respect thereto. |
TABLE II SECURITIES SOLD DURING THE PAST 3 MONTHS
Furnish the following information as to all securities of the issuer sold during the past 3 months by the person
for whose account the securities are to be sold.
Name and Address of Seller |
Title of Securities Sold |
Date of SaleM | Amount of Securities Sold | Gross Proceeds |
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Mark L. Groeneman 3906 Valley Green Court Houston, Texas 77059 |
Common Stock |
02/25/2004 |
15000 |
72000 |
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REMARKS: | ||
INSTRUCTIONS: | ATTENTION: | |
See the definition of "person" in paragraph (a) of Rule 144. Information is to be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice. | The person for whose account the securities to which this notice relates are to be sold hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publicly disclosed. | |
02/27/2004 |
/s/ Mark L. Groeneman |
|
DATE OF NOTICE | (SIGNATURE) |
The notice shall be signed by the person for whose account the securities are to be sold. At least one copy of the notice shall be manually signed.
Any copies not manually signed shall bear typed or printed signatures.
ATTENTION: Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001)
SEC 1147 (7-97)