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FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL
[ ] CHECK THIS BOX IF NO LONGER WASHINGTON, D.C. 20549 OMB NUMBER 3235-0287
SUBJECT TO SECTION 16. FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP EXPIRES: SEPTEMBER 30, 1998
OR FORM 5 OBLIGATIONS MAY ESTIMATED AVERAGE BURDEN
CONTINUE. SEE INSTRUCTION 1(B). HOURS PER RESPONSE.....0.5
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(f) of the Investment Company Act of 1940
(PRINT OR TYPE RESPONSES)
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or 6. Relationship of Reporting Person(s) to Issuer
Trading Symbol (Check all applicable)
X Director 10% Owner
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Officer Other
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(give title below) (specify below)
Sheridan, III, Robert H. Cumulus Media Inc. (CMLS)
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(Last) (First) (Middle) 3. IRS 4. Statement
or Social for
Security Month/Year
Number of
Reporting
Person
(Voluntary)
c/o BA Capital Company, L.P.
f/k/a NationsBanc Capital Corporation 12/99
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(Street) 5. If 7. Individual or Joint/Group Filing (Check Applicable
Amendment, Line)
Date of x Form filed by One Reporting Person
100 North Tryon Street, Floor 25 Original ---
Charlotte, North Carolina 28255 (Month/Year) ___ Form filed by More than One Reporting Person
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(City) (State) (Zip) TABLE I-- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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5. Amount of 6. Owner-
Securities ship
2. Trans- 3. Trans- 4. Securities Acquired (A) Beneficially Form:
action action or Disposed of (D) Owned at Direct 7. Nature of
Date Code (Instr. 3, 4 and 5) End of (D) or Indirect
1. Title of (Month/ (Instr. 8) -------------------------------- Month Indirect Beneficial
Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership
(Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4)
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No securities owned
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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)
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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7.
5. 6. Title and
Number of Date Exer- Amount of
Derivative cisable and Underlying
2. 4. Securities Expiration Securities
Conver- 3. Trans- Acquired (A) Date (Month/ (Instr. 3
sion or Trans- action or Disposed Day/Year) and 4)
1. Exercise action Code of (D) -------------- ----------------------
Title of Price of Date (Instr. (Instr. 3, Date Amount
Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num-
Security ative Day/ -------- ---------- cis- ation ber of
(Instr. 3) Security Year) Code V (A) (D) able Date Title Shares
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No securities owned
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10.
Ownership
9. Form of
8. Number of Deriv-
Price derivative ative
of Securities Security:
Deriv- Benefi- Direct 11.
ative cially (D) or Nature of
Secur- Owned at Indirect Indirect
ity End of (I) Beneficial
(Instr. Month (Instr. Ownership
5) (Instr. 4) 4) (Instr. 4)
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Explanation of Responses:
** Intentional misstatements or omissions of /s/ Robert H. Sheridan, III 12/9/99
facts constitute Federal Criminal Violations. -------------------------------- ------------
SEE 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ** Signature of Reporting Person Date
Robert H. Sheridan, III
Note: File three copies of this Form, one of which must be manually signed. If
space is insufficient, SEE Instruction 6 for procedure.
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.
Page 2
Sec 1474(7-96)
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