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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 | ||||||||
Option (right to buy) (7) | $ 13.04 | 12/31/2004 | X | 161,667 | 07/08/2003 | 01/07/2005 | Class A Common Stock | 161,667 | $ 0 | 0 | I | As settlor (1) | |||
Class B Common Stock | (8) | 02/16/2005 | P | 18,012 | (8) | (8) | Class A Common Stock | 18,012 | $ 20.1 | 18,012 | I | As settlor (1) | |||
Class B Common Stock | $ 0 (8) | (8) | (8) | Class A Common Stock | 22,784 | 22,784 | I | As settlor (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
JOHNSON H FISK 555 MAIN STREET RACINE, WI 53403 |
13(d) Group |
/s/ Johnson, H. Fisk | 05/20/2005 | |
**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) | H. Fisk Johnson reports these shares as settlor and beneficiary of the Gift Trust. Dr. Johnson held the reported option directly until it was transferred to the Gift Trust in a transaction exempt from Section 16 under Rule 16a-13. |
(2) | H. Fisk Johnson is filing this Form 4 because he may be deemed (but does not hereby admit that he is) part of a 13(d) group that owns more than 10% of Johnson Outdoors outstanding common stock. This Form 4 reports the shares of Johnson Outdoors common stock in which Dr. Johnson may be deemed to have a pecuniary interest under Rule 16a-1(a)(2). |
(3) | H. Fisk Johnson reports these shares as settlor and beneficiary of the H. Fisk Johnson Third Party Gift and Inheritance Trust (the "Gift Trust"), which is the managing member of the HFJ III Family Line Investments LLC, Series II (the "HFJ LLC"). Dr. Johnson disclaims beneficial ownership of all shares held by the HFJ LLC in which he does not have a pecuniary interest. |
(4) | H. Fisk Johnson reports these shares as settlor and beneficiary of the H. Fisk Johnson Revocable Trust (the "Trust"), which beneficially owns the reported shares directly, or indirectly as a shareholder of certain corporations and as the general partner of certain limited partnerships. Dr. Johnson reports all shares held by certain corporations of which the Trust may be deemed to be a controlling shareholder. In addition, Dr. Johnson reports all shares held by certain limited partnerships of which the Trust is a general partner. Due to the nature of such limited partnerships, it is impractical to determine the Trust's proportionate interest (as defined by Rule 16a-1(a)(2)(ii)(B)) in such limited partnerships. Dr. Johnson disclaims beneficial ownership of all shares directly or indirectly held by the Trust in which he does not have a pecuniary interest. |
(5) | H. Fisk Johnson reports these shares as the controlling shareholder of a corporation, which beneficially owns the reported shares directly. Dr. Johnson disclaims beneficial ownership of all shares held by the corporation in which he does not have a pecuniary interest. |
(6) | H. Fisk Johnson reports these shares as the sole trustee of certain trusts for Johnson family members, which beneficially own the reported shares directly. Dr. Johnson disclaims beneficial ownership of all shares held by the trusts in which he does not have a pecuniary interest. |
(7) | Stock option granted pursuant to that certain Option Agreement, dated July 8, 2003, by and among the Samuel C. Johnson 1988 Trust Number 1 dated September 14, 1988, as amended and restated, Helen P. Johnson Leipold, S. Curtis Johnson, H. Fisk Johnson and Winifred J. Marquart. |
(8) | Class B Common Stock is convertible at any time on a one-share-for-one-share basis into Class A Common Stock. |