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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 | ||||||||
Common Stock, $.01 par value | $ 0.2725 | 01/31/2007 | C | 1,643,460 | 12/08/2006 | (3) | Common Stock | 1,643,460 | $ 0 | 0 | I | by control group of direct owner |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BROOKE HOLDINGS INC 210 W. STATE STREET PHILLIPSBURG, KS 67661 |
X | Member of 13(d) group | ||
ORR ROBERT D 210 W. STATE STREET PHILLIPSBURG, KS 67661 |
X | X | Chairman, President and CEO | Member of 13(d) group |
ORR LELAND G 210 W. STATE STREET PHILLIPSBURG, KS 67661 |
X | Member of 13(d) group | ||
LARSON ANITA F 10950 GRANDVIEW DRIVE SUITE 600 OVERLAND PARK, KS 66210 |
X | Member of 13(d) group | ||
LOWRY SHAWN 10950 GRANDVIEW DRIVE, SUITE 600 OVERLAND PARK, KS 66210 |
X | Member of 13(d) group | ||
LOWRY MICHAEL 10950 GRANDVIEW DRIVE, SUITE 600 OVERLAND PARK, KS 66210 |
X | Member of 13(d) group | ||
GARST KYLE L 10950 GRANDVIEW DRIVE, SUITE 600 OVERLAND PARK, KS 66210 |
X | Member of 13(d) group |
/s/ Robert Orr for Brooke Holdings, Inc. | 02/02/2007 | |
**Signature of Reporting Person | Date | |
/s/ Robert D. Orr | 02/02/2007 | |
**Signature of Reporting Person | Date | |
/s/ Leland Orr | 02/02/2007 | |
**Signature of Reporting Person | Date | |
Anita F. Larson | 02/02/2007 | |
**Signature of Reporting Person | Date | |
/s/ Shawn T. Lowry | 02/02/2007 | |
**Signature of Reporting Person | Date | |
/s/ Michael Lowry | 02/02/2007 | |
**Signature of Reporting Person | Date | |
/s/ Kyle L. Garst | 02/02/2007 | |
**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) | The par value changed from $.10 per share to $.01 per share on January 31, 2007. |
(2) | Brooke Holdings, Inc. and the following executive officers of Brooke Corporation and/or its subsidiaries: Robert D. Orr, Leland G. Orr, Anita F. Larson, Shawn T. Lowry, Michael S. Lowry and Kyle L. Garst have orally agreed to vote their shares of Brooke Corporation common stock together and, as a group, beneficially owned 52.46% of their shares of the Brooke common stock as of October 31, 2006. Brooke Corporation directly owns the shares here reported. As of October 31, 2006, the beneficial ownership percentages in Brooke stock of the members of the control group are as follows: Brooke Holdings, Inc. 46.53%; Robert D. Orr 46.86%; Leland G. Orr 10.18%; Anita F. Larson 1.36%; Shawn T. Lowry 1.32%; Michael S. Lowry 1.18% and Kyle L. Garst 1.35%. |
(3) | None. The warrant has no expiration date. |