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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who 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 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Mandatorily Conv Cumulative Part Pref Stock, Series B | $ 1 (1) | 05/24/2012 | C | 29,864.74 | (2) | (2) | Non-Voting Common Stock | 1,493,237 | $ 50 | 0 | D | ||||
Director Stock Option | $ 13.19 | (3) | 05/01/2014 | Common Stock | 158 | 908 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Romine Michael J. 414 CHURCH ST. SANDPOINT, ID 83864 |
X |
Susan A. Pleasant, POA | 05/24/2012 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | 29,864.74 shares of Mandatorily Convertible Participating Preferred Stock, Series B were automatically converted into 1,493,237 shares of Non-Voting Common Stock on May 24, 2012, following shareholder approval on May 17, 2012 of an amendment to the Company's Articles of Incorporation authorizing shares of Non-Voting Common Stock. The original cost basis of the Preferred Stock, Series B was $50 per share, with a resulting cost basis of $1 per share at the conversion ratio of 50:1. |
(2) | The Preferred Stock, Series B was automatically convertible upon receiving shareholder approval of the article amendment and had no expiration date. |
(3) | The option vested in five equal annual installments beginning on May 1, 2005 and the price and number of shares were adjusted for a 3:2 stock dividend in March 2005 and 10% stock dividends in May 2006 and 2007. |