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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
ROONEY THOMAS S JR C/O INSITUFORM TECHNOLOGIES, INC. 702 SPIRIT 40 PARK DRIVE CHESTERFIELD, MO 63005 |
X | President & CEO |
/s/ Thomas S. Rooney, Jr. | 12/20/2004 | |
**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) | Forfeiture of restricted stock awarded on May 27, 2003, under the amended and restated 2001 Employee Equity Incentive Plan. The restrictions were to lapse on May 27, 2006, provided that certain performance goals were met as of March 31, 2004. The performance goals were not met as of March 31, 2004, and the shares of restricted stock reported herein were forfeited by Mr. Rooney as of April 29, 2004. |
(2) | Number of shares owned as of April 29, 2004, the date of the latest transaction reported herein. Mr. Rooney acquired 26,000 shares of restricted stock on October 27, 2004, which acquisition has been previously reported on a separate Form 4 filed on October 29, 2004. |