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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 | |
LARSEN LAWRENCE W CENTRAL INDUSTRIAL SUPPLY 2916 WALKENT DRIVE NW GRAND RAPIDS, MI 49504 |
X |
/s/ Jerome M. Schwartz Attorney-in-fact | 07/23/2007 | |
**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) | These shares were held by Jet Products, Inc. Profit Sharing Plan #2, for which Mr. Larsen is the trustee, and one of the beneficiaries. Mr. Larsen disclaims beneficial ownership of these shares, except to the extent of his pecuniary interest in the shares. |
(2) | Mr. Larsen is the trustee, and one of the beneficiaries of the Jet Products, Inc. Profit Sharing Plan #2. Mr. Larsen disclaims beneficial ownership of the shares held by this trust, except to the extent of his pecuniary interest in the shares. |
(3) | This share amount includes shares Mr. Larsen acquired since his last report of common stock ownership pursuant to the issuer's 5% stock dividends paid on May 4, 2007 and in certain prior years. |
(4) | Includes approximately 18,089 shares received on or about June 19, 2006 as a gift from Mr. Larsen to his spouse. This share amount also includes shares acquired by Mr. Larsen's spouse since Mr. Larsen's last report of common stock ownership, pursuant to the issuer's 5% stock dividends paid on May 4, 2007 and in certain prior years. |