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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT 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 2270 (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 at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HILLENBRAND W AUGUST 700 STATE ROUTE 46E BATESVILLE, IN 47006 |
 X |  |  |  |
W August Hillenbrand | 11/04/2005 | |
**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) | Price - Not Applicable. |
(2) | This amount reflects transfers of limited liability company interests to the GRAT of which the Reporting Person is the trustee. Each transfer of limited liability company interests to the GRAT qualifies as only a change in the form of the Reporting Person's beneficial ownership and, as such, has not been previously reported. |
(3) | The Reporting Person disclaims beneficial ownership of these securities. |
(4) | The aggregate holdings were reduced by 176,500 shares of stock due to the liquidation of two trusts which were distributed to family members. |
(5) | The Reporting Person is only a limited partner and he disclaims beneficial ownership of the securities held by the limited partnership except to the extent of his pecuniary interest. |
(6) | This amount reflects transfers of limited liability company interests to GRATs of which the Reporting Person is the trustee. Each transfer of limited liability company interests to the GRATs qualifies as only a change in the form of the Reporting Person's beneficial ownership and, as such, has not been previously reported. |
(7) | This amount reflects transfers of limited liability company interests to the GRAT. Each transfer of limited liability company interests to the GRAT qualifies as only a change in the form of ownership and, as such, has not been previously reported. Reporting person disclaims beneficial ownership of these securities. |