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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Suriyakumar Kumarakulasingam C/O AMERICAN REPROGRAPHICS COMPANY 1981 N. BROADWAY, SUITE 385 WALNUT CREEK, CA 94596 |
X | X | Chairman, President and CEO |
/s/ Kumarakulasingam Suriyakumar | 12/18/2012 | |
**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) | The reporting person is voluntarily reporting these transactions on Form 4, rather than Form 5, for ease of reference. The transactions reported herein do not change the total number of beneficially owned shares of the Reporting Person. |
(2) | Represents a distribution of shares from the Suriyakumar 2008 Annuity Trust I to the Suriyakumar Family Trust. |
(3) | Represents a distribution of shares from the Suriyakumar 2008 Annuity Trust II to the Suriyakumar Family Trust. |
(4) | Represents a pro rata in-kind distribution of Common Stock by Dieterich Post Company to partners or members and includes subsequent distributions by general partners or managing members to their respective partners or members. |
(5) | Represents shares received in a pro rata distribution from Dieterich Post Company. |
(6) | Mr. Suriyakumar has an ownership of 44% in Micro Device, Inc. and serves on its board of directors so he could be deemed to have beneficial ownership of these shares. Mr. Suriyakumar disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest therein. |