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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 | |
CASSARD DAVID M WATERS CORPORATION, WATERS BUILDING 161 OTTAWA NW, SUITE 104 GRAND RAPIDS, MI 49503-2799 |
 X |  |  |  |
/s/Jerome M. Schwartz Attorney-in-fact | 02/02/2005 | |
**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) | The reporting person disclaims beneficial ownership of the issuer's common stock held by the trust except to the extent of his pecuniary interest in the stock. |
(2) | The reporting person became the indirect beneficial owner of these shares as a result of becoming the successor trustee of a trust upon the death of the prior trustee. |
(3) | These shares were sold by the reporting person as successor trustee of a trust following the death of the prior sole trustee and primary beneficiary of the trust, and the proceeds were distributed to the trust beneficiaries. |
(4) | Includes an aggregate of 95.848 shares acquired on 12/10/2003, 3/10/2004, 6/10/2004, 9/10/2004 and 12/10/2004 by reinvesting cash dividends under the issuer's dividend reinvestment plan, and 385 shares acquired pursuant to the issuer's 5% stock dividend paid May 3, 2004. |