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Postal Code
(c)
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2. ..........................................................................................................................................
Name of Bidder
(a) .............................................................................
Address of Bidder
3. ..........................................................................................................
Title or Class of Securities Subject to Tender Offer
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Postal Code
Item 1. Subject Company and Class of Security Subject to the Tender Offer
(a) State the name of the subject company and the address of its principal executive offices.
(b) State the exact title and the amount of securities outstanding of the class of security being sought as
of the most recent practicable date and the exact amount of such securities being sought and the
consideration being offered therefor.
(c) Identify the principal market in which such securities are being traded and, if the principal market is
an exchange, state the high and low sales prices for such securities on such exchange for each
quarterly period during the past two years. If the principal market is not an exchange, state the
range of high and low bid quotations for each quarterly period during the past two years, the source of
such
quotations and, if there is currently no established trading market for such securities (excluding
limited or sporadic quotations), furnish a statement to that effect.
Item 2. Identity and Background
If the person filing this Form or any person enumerated in subparagraph (d)(1) of the General
Instructions to this Form is a corporation, partnership, syndicate or other group of persons, state its name,
the place of its organization, its principal business, the address of its principal office and the information
required by (e) and (f) of this Item. If the person filing this Form or any person enumerated in subparagraph
(d)(1) of the General Instructions is a natural person, provide the information specified in (a) through (g) of
this Item with respect to such person(s).
(a) Name;
(b) Nature of any affiliation between such person and the issuer;
(c) Residence or business address;
(d) Present principal occupation or employment and the name, principal business and address of any
corporation or other organization in which such employment is conducted;
(e) Whether or not, during the last five years, such person has been convicted in a criminal proceeding
(excluding traffic violations or similar misdemeanors) and, if so, give the dates, nature of conviction,
name and location of court, any penalty imposed, or other disposition of the case;
(f) Whether or not, during the last five years, such person was a party to a civil proceeding of a judicial
or administrative body of competent jurisdiction, domestic or foreign, and as a result of such
proceeding was or is subject to any order, judgment or decree, not subsequently reversed,
suspended or vacated, permanently or temporarily enjoining, barring, suspending or otherwise
limiting involvement in any type of business, securities, commodities or banking; and
(g) Citizenship
Item 3. Purpose of the Tender Offer and Plans or Proposals of the Bidder
State the purpose or purposes of the tender offer, and describe any plans or proposals which relate to or
would result in:
(a) An extraordinary corporate transaction, such as a merger, reorganization or liquidation, involving the
issuer or any of its subsidiaries;
SEC Form 19-1
4
February 2001
(b) A sale or transfer of a material amount of assets of the issuer or any of its subsidiaries;
(c) Any change in the present board of directors or management of the issuer including, but not limited
to, any plan or proposal to change the number or term of directors, to fill any existing vacancy on
the board or to change any material term of the employment contract of any executive officer;
(d) Any material change in the present dividend rate or policy or indebtedness or capitalization of the
issuer;
(e) Any other material change in the issuer's corporate structure or business;
(f) Causing any class of equity securities of the issuer which is listed on an exchange to be no longer
listed; or
(g) Causing the issuer to no longer be subject to the reporting requirements of SRC Rule 17.
Item 4. Interest in Securities of the Issuer
(a) State the aggregate number of shares of the class of equity securities of the issuer which is the
subject of the tender offer and the percentage of the class represented by such shares beneficially
owned by each person named in Item 2 of this Form and by each associate and majority owned
subsidiary of such person.
(b) Describe any transaction in the class of equity securities of the issuer which is the subject of the
tender offer that was effected during the past sixty (60) days by the persons named in response to
paragraph (a) of this Item or by any director or executive officer of such person.
Item 5. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the
Issuer (This information may be omitted if the tender offer is being made by the Issuer)
Describe any contracts, arrangements, understandings or relationships among the persons named in
Item 2 and between such persons and any person with respect to any securities of the issuer, including but
not limited to transfer or voting of any of the securities, finder's fees, joint ventures, loan or option
arrangements, puts or calls, guarantees of profits, division of profits or loss, or the giving or withholding of
proxies, naming the person with whom such contracts, arrangements, understandings or relationships have
been entered into. Include such information for any of the securities that are pledged or otherwise subject to
a contingency the occurrence of which would give another person voting power or investment power over
such securities except that disclosure of standard default and similar provisions contained in loan
agreements need not be included.
Item 6. Materials to be Filed as Exhibits
(a) Tender offer material which is published, sent or given to security holders by or on behalf of the
person filing this statement in connection with the tender offer; and
(b) Any document setting forth the terms of any contract, arrangements, understandings or relationships
referred to in Item 5 of this Form.
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set
forth in this report is true, complete and correct.
This report is signed in the City
of ................................................. on ..............................................., 20..........
By: ................................................
(Signature)
....................................................
(Name/Title)