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FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549 ---------------------------
OMB APPROVAL
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ---------------------------
/ / Check this box if no OMB Number: 3235-0287
longer subject to Filed pursuant to Section 16(a) of the Securities Expires: September 30, 1998
Section 16. Form 4 Exchange Act of 1934, Section 17(a) of the Estimated average burden
or Form 5 obligations Public Utility Holding Company Act of 1935 hours per response......0.5
may continue. See or Section 30(f) of the Investment Company ---------------------------
Instruction 1(b). Act of 1940
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
Burchett John A. Hanover Capital Mortgage Holdings, Inc. HMC to Issuer (Check all applicable)
- ------------------------------------------- -------------------------------------------- X Director 10% Owner
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year X Officer (give Other (Specify
90 West Street Suite 1508 Person (Voluntary) February, 1999 ---- title --- below)
- --------------------------------------------- ------------------- below)
(Street) -------------------- 5. If Amendment, President, CEO, Chairman of Board
New York, New York 10006 Date of Original 7. Individual or Joint/Group Filing
- --------------------------------------------- (Month/Year) (Check Applicable Line)
(City) (State) (Zip) X_ Form filed by One Reporting Person
------------ __ Form filed by more than One
Reporting Person
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TABLE 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Instr. 8) End of Month Direct Benefi-
(Month/ (Instr. 3 and 4) (D) or cial
Day/ --------------------------------------- Indirect Owner-
Year) Code V Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr.
4)
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Common Stock 2/2/99 P 5,000 A 4.375 D
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Common Stock* 2/4/99 P 3,000 A 4.250 413,277 D
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Common Stock** 3,000 I
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* Purchase of Units consisting of one share of common stock and one warrant per Unit.
** Held by Children.
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
(Over)
(Print or Type Responses) SEC 1474 (7-96)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv-
Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative
Deriv- Day/ Disposed of (D) (Month/Day/ Secur-
ative Year) (Instr. 3, 4, Year) ity
Security and 5) (Instr. 5)
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Date Expira- Amount or
-------------------------- Exer- tion Title Number of
Code V (A) (D) cisable Date Shares
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Common
Rights to Acquire Stock 119,167
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Options (Rights Common
to Acquire) Stock 113,737
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Common
Warrants* 15.00 2/4/99 P 3,000 3/15/98 9/15/00 Stock 3,000 4.250
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Common
Warrants 15.00 2/9/99 P 18,000 3/15/98 9/15/00 Stock 18,000 .125
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Common
Warrants** 15.00 3/15/98 9/15/00 Stock 3,000
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1. Title of Derivative 9. Number of 10. Ownership 11. Nature of
Security Derivative Form of Indirect
(Instr. 3) Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at End Direct (D) (Instr. 4)
of Month or Indirect (I)
(Instr. 4) (Instr. 4)
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Rights to Acquire 119,167 D
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Options (Rights
to Acquire) 113,737 D
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Warrants* D
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Warrants 22,000 D
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Warrants** 3,000 I
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Explanation of Responses:
* Purchase of Units consisting of one share of common stock and one warrant per Unit. /s/ John A. Burchett 3/9/99
** Held by Children. ------------------------------- -------
*** Intentional misstatements or omissions of facts constitute Federal Criminal **Signature of Reporting Person Date
Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). John A. Burchett
Note. File three copies of this Form, one of which must be manually signed. Page 2
If space provided is insufficient, see Instruction 6 for procedure. (Bulletin No. 177, 10-15-97)
Potential persons who are to respond to the collection of information contained in this form are not
required to respond unless the form displays a currently valid OMB Number.
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