U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
[ ] Check this box if no longer subject of Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
================================================================================
1. Name and Address of Reporting Person*
ROSE, MARK S.
- --------------------------------------------------------------------------------
(Last) (First) (Middle)
35 Boylan Lane
- --------------------------------------------------------------------------------
(Street)
Blue Point, NY 11715
- --------------------------------------------------------------------------------
(City) (State) (Zip)
================================================================================
2. Issuer Name and Ticker or Trading Symbol
EMPIRE OF CAROLINA - "EMP"
================================================================================
3. IRS or Social Security Number of Reporting Person (Voluntary)
================================================================================
4. Statement for Month/Year
September 1999
================================================================================
5. If Amendment, Date of Original (Month/Year)
================================================================================
6. Relationship of Reporting Person to Issuer
(Check all applicable)
[ X ] Director [ X ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
================================================================================
7. Individual or Joint/Group Filing (Check applicable line)
[ X ] Form filed by one Reporting Person [ ] Form filed by more than one
Reporting Person
<PAGE>
================================================================================
Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
================================================================================
<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock 9/21/99 P 28,846 A (1) (I) By spouse
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 9/21/99 P 432,692 A (1) 2,486,538(2) (D)
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
====================================================================================================================================
</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Printed or Type Response)
<PAGE>
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially
Owned (e.g., puts, calls, warrants, options, convertible securities)
================================================================================
<TABLE>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
of Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
- ------------------------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
====================================================================================================================================
</TABLE>
Explanation of Responses:
(1) On May 28, 1998, the Issuer acquired all of the outstanding shares of Apple
Sports, Inc. and Apple Golf Shoes, Inc. In consideration for his shares of
Apple Golf Shoes, Inc. and Apple Sports, Inc., Reporting Person received
directly 125,000 shares of the Issuer's common stock and 1,750,000 shares
indirectly through Mark Rose Companies, Ltd., which is controlled by
Reporting Person. Under the provisions of the Share Purchase Agreement,
Issuer was obligated to issue additional shares to each of the sellers,
including Reporting Person, if the market price of Issuer's common stock
was not greater than $2.00 for a period of more than 45 days from an
adjustment date as determined in the Share Purchase Agreement (see Issuer's
Current Report on Form 8-K filed with the Commission on June 12, 1998 for
details of the determination). This condition occurred and, on September
21, 1999, Issuer was required to issue an additional 403,846 shares to Mark
Rose Companies, Ltd., an additional 28,846 to the Reporting Person
individually, and an additional 28,846 shares to Reporting Person's spouse.
For purposes of valuation, the closing price of Issuer's common stock on
the American Stock Exchange on September 21, 1999 (the date of issuance)
was $.375 per share.
(2) Includes 153,846 shares of Common Stock owned by Reporting Person's spouse.
/s/ Mark S. Rose October 12, 1999
----------------------------------------- -----------------------
**Signature of Reporting Person Date
MARK S. ROSE
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedures.
Page 2
