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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 | ||||||||
Class B Common Stock | (6) | (6) | (6) | Class A Common Stock | 45,000 | 45,000 | I | By Trust (5) | |||||||
Class B Common Stock | (6) | 11/22/2004 | C | 12,000 | (6) | (6) | Class A Common Stock | 12,000 | $ 0 | 219,941 | I | By Voting Trust (3) | |||
Class B Common Stock | (6) | (6) | (6) | Class A Common Stock | 298,929 | 298,929 | I | By Voting Trust (4) | |||||||
Class B Common Stock | (6) | (6) | (6) | Class A Common Stock | 18,130 | 18,130 | I | By Voting Trust (7) | |||||||
Class B Common Stock | (6) | (6) | (6) | Class A Common Stock | 9,234 | 9,234 | I | By Voting Trust (8) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ROMAIN GAYLE S 3200 NW YEON AVENUE PORTLAND, OR 97210 |
X |
Ilene Dobrow Davidson, Attorney-In-Fact | 11/23/2004 | |
**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) | Represents shares held by Paul Romain, the spouse of reporting person, as Custodian under the Oregon Uniform Transfers to Minors Act F/B/O Danielle Romain. |
(2) | Represents shares held by Paul Romain, the spouse of reporting person, as Custodian under the Oregon Uniform Transfers to Minors Act F/B/O Mikhael Romain. |
(3) | Voting trust certificates or shares, as the case may be, are held by Gayle S. Romain and Rita S. Philip, Trustees of Gayle S. Romain Family Trust U/A/D October 9, 1995. |
(4) | Voting trust certificates or shares, as the case may be, are held by Dina S. Meier and Gayle S. Romain, Trustees of the Dina S. Meier Revocable Trust U/A/D 8/19/94. |
(5) | Voting trust certificates or shares, as the case may be, are held by Gayle S. Romain, Trustee for Gayle S. Romain, et al, under Trust Agreement dated January 30, 1970. |
(6) | Class B Common Stock is immediately convertible on a one-for-one basis into Class A Common Stock and has no expiration date. |
(7) | Voting trust certificates are held by Gayle S. Romain, Family Trustee, and Mardi S. Schnitzer, Independent Trustee, U/A/D December 22, 1994 F/B/O Laura H. Rosencrantz. |
(8) | Voting trust certificates are held by Gayle S. Romain, Family Trustee, and Mardi S. Schnitzer, Independent Trustee, U/A/D December 22, 1994 F/B/O Bryan L. Rosencrantz. |
(9) | The shares were sold pursuant to a pre-established Rule 10b5-1 plan. |