Form 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 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(f) of the Investment Company Act of 1940 |
OMB APPROVAL | |
OMB Number: 3235-0287 | |||
Expires: PENDING | |||
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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 |
(Print or Type Responses)
1. Name and Address of Reporting
Person* |
2. Issuer Name and Ticker or Trading Symbol Interface, Inc. (IFSIA) |
6. Relationship of Reporting Person(s) to
Issuer ____ Officer (give Other (specify title below) below) ____________________________ | ||||||||||
(Last) (First) (Middle) Baambrugse Zuwe 228 |
3. I.R.S. Identification Number of Reporting Person, if an entity voluntary) | 4.
Statement
for Month/Year November 2001 | ||||||||||
(Street) 3645 Am Vinkeveen The Netherlands |
5. If Amendment, Date of |
7. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person ____ Form filed by More than One Reporting Person | ||||||||||
(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||
1. Title of Security |
2. Transaction Date |
3.
Transaction |
4. Securities Acquired (A) or Disposed
of |
5. Amount of Securities Beneficially Owned at End of Month |
6. Owner- |
7. Nature of Indirect Beneficial Ownership | ||||||
Code |
V |
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. | ||
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 4 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially
Owned |
|
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 | ||||
Code |
V |
(A) |
(D) |
Date |
Expiration |
Title |
Amount | |||||||
Employee Stock Option |
4.75 |
11/26/01 |
A |
V |
5,000 |
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*11/26/02 |
11/26/11 |
Class A or Class B Common Stock |
5,000 |
0 |
5,000 |
D |
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Explanation of Responses: |
** |
Intentional misstatements or omissions of facts constitute Federal
Criminal Violations. |
/s/ Clarinus C. Th. van Andel
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1-24-02
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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 required to respond unless the form displays a currently valid OMB Number. |
Page 2 |