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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 | ||||||||
Series A-T Preferred Stock (1) | $ 5 (2) | 08/04/2009 | J(3) | 60,000 | 08/05/2010(4) | 08/01/2016 | Common Stock, $1 par value | 12,000,000 (5) | $ 0 | 60,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
TENGELMANN WARENHANDELSGESELLSCHAFT KG WISSOLLSTRASSE 5-43 45478 MULHEIM AN DER RUHR, 2M |
X | |||
TENGELMANN VERWALTUNGS UND BETEILIGUNGS GMBH WISSOLLSTRASSE 5-43 45478 MULHEIM AN DER RUHR, 2M |
X | |||
HAUB KARL ERIVAN WARDER WISSOLLSTRASSE 5-43 45478 MULHEIM AN DER RUHR, 2M |
X | |||
HAUB CHRISTIAN W E 2 PARAGON DRIVE MONTVALE, NJ 07645 |
X | |||
HAUB ERIVAN KARL WISSOLLSTRASSE 5-43 45478 MULHEIM AN DER RUHR, 2M |
X |
Karl-Ervian Warder Haub, by Christian Wilhelm Erich Haub (Attorney-in-Fact) | 08/06/2009 | |
**Signature of Reporting Person | Date | |
Tengelmann Warenhandelsgesellschaft KG, by Tengelmann Verwaltungs-und Beteiligungs GmbH, as Managing Partner, by Christian Wilhelm Erich Haub, Co-CEO | 08/06/2009 | |
**Signature of Reporting Person | Date | |
Christian Wilhelm Erich Haub | 08/06/2009 | |
**Signature of Reporting Person | Date | |
Tenglemann Verwaltungs und Beteiligungs GMBH, by Christian Wilhelm Erich Haub, Co-CEO | 08/06/2009 | |
**Signature of Reporting Person | Date | |
Erivan Karl Haub, by Christian Wilhelm Haub (Attorney-in-Fact) | 08/06/2009 | |
**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 8% Cumulative Convertible Preferred Stock, Series A-T, without par value, due August 1, 2016 (the "Series A-T Preferred Stock"). |
(2) | The Series A-T Preferred Stock has a liquidation preference of $1,000 per share and each share of Series A-T Preferred Stock is initially convertible into 200 shares of Common Stock (the "Conversion Rate"), which represents a Common Stock price per share of $5.00. The Conversion Rate is subject to change. |
(3) | The full right, title and ownership of the Series A-T Preferred Stock was acquired pursuant to a contribution from limited partners of Tengelmann Warenhandelsgesellschaft KG, a limited partnership organized under the laws of the Federal Republic of Germany ("Tengelmann"). Erivan Karl Haub, Christian Wilhelm Erich Haub and Karl-Erivan Warder Haub expressly declare that the filing of this statement is not an admission that they are, for the purposes of Section 16 of the Securities Exchange Act of 1934, as amended, the beneficial owner of the Series A-T Preferred Stock owned by Tengelmann. |
(4) | The Series A-T Preferred Stock is not presently convertible into Common Stock but will become convertible on August 5, 2010, at the holder's option, subject to any limitations imposed by any stockholder approval requirements of the New York Stock Exchange. |
(5) | The value set forth in this field is based upon the Conversion Rate as of August 4, 2009. |