Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly . Over*If the form is filed by more than one reporting person, see Instruction 4(b)(v) |
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FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) |
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1. Title of Derivative Security |
2. Conver- |
3. Trans- |
3A |
4. Transac- |
5. Number of Deriv- |
6. Date Exercisable |
7. Title and Amount of Underlying |
8. Price |
9. Number |
10. Owner- |
11. Nature |
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Security |
(Month/ |
(Month/ |
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Date |
Expiration |
|
Amount or |
(Instr. |
icially |
Ity |
Ship |
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Code |
V |
(A) |
(D) |
Exercisable |
Date |
Title |
Number of Shares |
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Month |
rect (I) |
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Options to Buy(1) |
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0 |
D |
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Explanation of Responses
** Intentional mistatements or omissions of facts constitute Federal Criminal Violations. |
Karl J. Grafe March 13, 2003 |
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
** Signature of Reporting Person Date |
|
Keith A. Jensen |
|
By: Karl J. Grafe, as Attorney-in-Fact |
Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see instruction 6 for procedure. |
Page 2 SEC 1474 (9-02) |