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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 | (3) | (3) | (3) | Class A Common Stock | 24,979 | 24,979 | I | By Voting Trust (2) | |||||||
Class B Common Stock | (3) | (3) | (3) | Class A Common Stock | 19,302 | 19,302 | I | By Voting Trust (4) | |||||||
Class B Common Stock | (3) | (3) | (3) | Class A Common Stock | 20,056 | 20,056 | I | By Voting Trust (5) | |||||||
Class B Common Stock | (3) | (3) | (3) | Class A Common Stock | 246,694 | 246,694 | I | By Voting Trust (6) | |||||||
Class B Common Stock | (3) | 09/22/2004 | G | V | 1,000 | (3) | (3) | Class A Common Stock | 1,000 | $ 0 | 1,000 | I | By Voting Trust (7) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
NOVACK KENNETH M 3200 NW YEON AVENUE PORTLAND, OR 97210 |
X | X | ||
NOVACK DEBORAH S 3200 NW YEON AVENUE PORTLAND, OR 97210 |
X |
Ilene Dobrow Davidson, Attorney-In-Fact | 03/03/2005 | |
**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) | Shares are held by Kevin P. Novack, an immediate family member of the reporting persons who may be deemed to share the same household. |
(2) | Voting trust certificates or shares, as the case may be, are held by Kenneth M. Novack and Deborah S. Novack, Trustees U/A/D July 31, 1991 F/B/O Kenneth M. Novack. |
(3) | Class B Common Stock is immediately convertible on a one-for-one basis into Class A Common Stock and has no expiration date. |
(4) | Voting trust certificates or shares, as the case may be, are held by the 1997 Melanie Novack Trust, dated 8/17/97, Deborah S. Novack and Kenneth M. Novack, collectively as Trustees. |
(5) | Voting trust certificates or shares, as the case may be, are held by the 1997 Kevin Novack Trust, dated 8/17/97, Deborah S. Novack and Kenneth M. Novack, collectively as Trustees. |
(6) | Voting trust certificates or shares, as the case may be, are held by Deborah S. Novack and Kenneth M. Novack, Trustees U/A/D July 31, 1991 F/B/O Deborah S. Novack. |
(7) | Voting Trust Certificates or shares, as the case may be, are held by Gary A. Schnitzer and Deborah Novack, Trustees, Gary A. Schnitzer Family Trust dated May 15, 1991. |