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OMB APPROVAL
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SECURITIES AND EXCHANGE COMMISSION OMB Number: 3235-0145
WASHINGTON, DC 20549 Expires: October 31, 1994
Estimated average burden
SCHEDULE 13D hours per form ..... 14.90
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Under the Securities Exchange Act of 1934
(Amendment No. 12)*
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CHICAGO RIVET & MACHINE CO., ("CVR")
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(Name of Issuer)
Common Shares, $1.00 par value
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(Title of Class of Securities)
168088 10 2
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(CUSIP Number)
c/o Walter W. Morrissey, Morrissey & Robinson, 1301 W. 22nd St., #401,
Oak Brook, IL 60523
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(Name, Address and Telephone Number of Person Authorized to
Receive Notices and Communications)
December 10, 1999
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(Date of Event which Requires Filing of this Statement)
If the filing person has previously filed a statement on Schedule 13G to report
the acquisition which is the subject of this Schedule 13D, and is filing this
schedule because of Rule 13d-1(b)(3) or (4), check the following box [ ].
Check the following box if a fee is being paid with the statement [ ]. (A fee is
not required only if the reporting person: (1) has a previous statement on file
reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7.)
NOTE: Six copies of this statement, including all exhibits, should be filed
with the Commission. See Rule 13d-1(a) for other parties to whom copies are to
be sent.
* The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter
disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
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CUSIP NO. 168088 10 2 13D PAGE 2 OF 7 PAGES
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1 NAMES OF REPORTING PERSONS
S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS
John A. Morrissey (SS# ###-##-####)
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4 SOURCE OF FUNDS*
Not applicable
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5 CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEM 2(d) OR 2(e) [ ]
Not applicable
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6 CITIZENSHIP OR PLACE OF ORGANIZATION
U.S.A.
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7 SOLE VOTING POWER
NUMBER OF
90,452
SHARES -----------------------------------------------------------------
8 SHARED VOTING POWER
BENEFICIALLY
-0-
OWNED BY EACH -----------------------------------------------------------------
9 SOLE DISPOSITIVE POWER
REPORTING
90,452
PERSON -----------------------------------------------------------------
10 SHARED DISPOSITIVE POWER
WITH
-0-
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11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
90,452
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12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES
CERTAIN SHARES* [ ]
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13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
7.9%
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14 TYPE OF REPORTING PERSON*
IN
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* SEE INSTRUCTIONS BEFORE FILLING OUT!
INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
(INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.
2 of 7
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CUSIP NO. 168088 10 2 13D PAGE 3 OF 7 PAGES
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- --------------------------------------------------------------------------------
1 NAMES OF REPORTING PERSONS
S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS
Walter W. Morrissey (SS# ###-##-####)
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2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
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3 SEC USE ONLY
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4 SOURCE OF FUNDS*
Not applicable
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5 CHECK IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT
TO ITEM 2(d) OR 2(e) [ ]
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6 CITIZENSHIP OR PLACE OF ORGANIZATION
U.S.A.
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7 SOLE VOTING POWER
NUMBER OF
84,120
SHARES -----------------------------------------------------------------
8 SHARED VOTING POWER
BENEFICIALLY
-0-
OWNED BY EACH -----------------------------------------------------------------
9 SOLE DISPOSITIVE POWER
REPORTING
84,120
PERSON -----------------------------------------------------------------
10 SHARED DISPOSITIVE POWER
WITH
-0-
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11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
84,120
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12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES
CERTAIN SHARES* [ ]
- --------------------------------------------------------------------------------
13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11)
7.2%
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14 TYPE OF REPORTING PERSON*
IN
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* SEE INSTRUCTIONS BEFORE FILLING OUT!
INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
(INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.
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AMENDMENT NO. 12
TO
SCHEDULE 13D
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DECEMBER 10, 1999
This Amendment No. 12 to Schedule 13D ("Statement") amends the Schedule
13D with respect to the Common Shares, $1.00 par value (the "Shares"), of
Chicago Rivet & Machine Co. (the "Company") filed by John A. Morrissey and
Walter W. Morrissey on or about January 9, 1986 with the Securities and Exchange
Commission, as modified by Amendment No. 1 to Schedule 13D ("Amendment No. 1")
filed on December 19, 1989, by Amendment No. 2 to Schedule 13D ("Amendment No.
2") filed on April 30, 1991, by Amendment No. 3 to Schedule 13D ("Amendment No.
3") filed on October 11, 1994, by Amendment No. 4 to Schedule 13D ("Amendment
No. 4") filed on May 10, 1995, by Amendment No. 6 to Schedule 13D ("Amendment
No. 6") filed on February 8, 1997, by Amendment No. 7 to Schedule 13D filed on
March 31, 1997 ("Amendment No. 7"), by Amendment No. 8 to Schedule 13D filed on
August 25, 1997 ("Amendment No. 8"), by Amendment No. 9 to Schedule 13D filed on
February 4, 1998 ("Amendment No. 9"), by Amendment No. 10 to Schedule 13D filed
November 10, 1998 ("Amendment No. 10"), and by Amendment No. 11 to Schedule 13D
filed September 1, 1999.
ITEM 1. SECURITY AND ISSUER.
No change
ITEM 2. IDENTITY AND BACKGROUND.
No change.
ITEM 3. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION.
The event requiring the filing of this Statement is the distribution of
4,000 shares of Common Stock on or about December 10, 1999, from the
estate of the spouse of the reporting person to their adult children.
The filing of this statement further reflects that 118 shares are owned
by an adult family member who lives and resides independently of the
reporting person.
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ITEM 4. PURPOSE OF TRANSACTION.
No change.
ITEM 5. INTEREST IN SECURITIES OF THE ISSUER.
Item 5 is amended and restated to the extent set forth below on behalf
of reporting persons John A. Morrissey and Walter W. Morrissey as
follows:
(a) and (b). As of the date of filing this "Statement", John A.
Morrissey beneficially owns 90,452 shares with sole voting and
dispositive power, or approximately 7.9% of the outstanding shares.
As of the date of filing this Statement, Walter W. Morrissey
beneficially owns 84,120 Shares with sole voting and dispositive power
or approximately 7.2% of the outstanding shares.
There is no change to the remainder of Paragraphs (a) and (b) of Item
5.
(c). No change.
(d). No change.
(e). No change.
ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT
TO SECURITIES OF THE ISSUER.
No change.
ITEM 7. MATERIAL TO BE FILED AS EXHIBITS.
Item 7 is amended to add the following exhibit:
Exhibit "1" - Agreement to File Amendment No. 12 to Schedule 13D
between John A. Morrissey and Walter W. Morrissey.
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SIGNATURES
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After reasonable inquiry and to the best of our knowledge and belief,
we certify that the information set forth in this Statement is true, complete
and correct.
DATED: December 10, 1999
/s/ John A. Morrissey
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JOHN A. MORRISSEY
/s/ Walter W. Morrissey
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WALTER W. MORRISSEY
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EXHIBIT "1"
AGREEMENT TO FILE SCHEDULE 13D
The persons named below hereby agree to file one Schedule 13D with
respect to their respective Common shares of Chicago Rivet & Machine Co.
reported in such Schedule. Such persons qualify for a single filing in
accordance with the requirements of Rule 13D-1(f).
DATED: December 10, 1999
/s/ John A. Morrissey
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JOHN A. MORRISSEY
/s/ Walter W. Morrissey
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WALTER W. MORRISSEY
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