Form 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |
OMB APPROVAL |
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OMB Number: 3235-0287 |
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Expires: December 31, 2001 |
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Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b). |
Estimated average burden |
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Form 3 Holdings Reported |
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Form 4 Holdings Reported |
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1. Name and Address of Reporting Person* Madonia, Frank |
2. Issuer Name and Ticker or Trading Symbol Miller Industries, Inc. (MLR) |
6. Relationship of Reporting Person(s) to Issuer Executive Vice President, Secretary and General Counsel |
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(Last) (First) (Middle) 8503 Hilltop Drive |
3. I.R.S. Identification Number of Reporting Person,
if an entity voluntary) |
4. Statement for Month/Year 2001 |
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(Street) Ooltewah, TN 37363 |
5. If Amendment, Date of Original (Month/Year) |
7. Individual or Joint/Group Filing |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date |
3. Transaction |
4. Securities Acquired (A) or Disposed of (D) |
5. Amount of Securities Beneficially Owned at End of Issuer's Fiscal Year |
6. Owner- |
7. Nature of Indirect Beneficial Ownership |
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Amount |
(A) or (D) |
Price |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
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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. |
(Over) |
FORM 5 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of Derivative Security |
2. Conversion or |
3. Transaction |
4. Transaction Code |
5. Number of Derivative |
6. Date Exercisable |
7. Title and Amount of |
8. Price of |
9.Number of |
10. Ownership |
11. Nature of |
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(A) |
(D) |
Date |
Expiration |
Title |
Amount |
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Stock Options |
$3.05 |
12/7/01 |
A |
5,000 |
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(1) |
12/7/11 |
Common Stock |
5,000 |
5,000 |
D |
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Explanation of Responses: (1) Options vest in four equal annual installments of 1,250 options beginning on the first anniversary of the grant date. |
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
/s/ Frank Madonia
**Signature of Reporting Person |
2-14-02
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Note: |
File three copies of this Form, one of which must be manually signed. |
Potential persons who are to respond to the collection of information contained in this form are not |
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