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Previous: LUND INTERNATIONAL HOLDINGS INC, 4, 1996-12-06 |
Next: PUTNAM CALIFORNIA TAX EXEMPT MONEY MARKET FUND, NSAR-B/A, 1996-12-06 |
<PAGE> 1
UNITED STATES
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 to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person
Mac M. Churchill
4065 Commercial Avenue
Northbrook, Illinois 60062
2. Issuer Name and Ticker or Trading Symbol
Lund International Holdings, Inc. (LUND)
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
November 1996
5. If Amendment, Date of Original (Month/Year)
Not Applicable
6. Relationship of Reporting Person to Issuer (Check all applicable)
/ / Director / / 10% Owner
/ / Officer (give title below) / x/ Other (specify
below)
Director of Old World Industries, Inc.
Page 1 of 4
<PAGE> 2
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<TABLE>
<CAPTION>
4. Securities Acquired (A)
3. Transaction or Disposed of (D)
2. Transaction Code (Instr. 8) (Instr. 3, 4, and 5)
1. Title of Security Date (Month/Day --------------- --------------------------------------
(Instr. 3) Year) Code | V Amount | (A) or (D) | Price
- --------------------- --------------- --------------- ----------------------------------------
<S> <C> <C> <C> <C> <C>
Common Stock 11/12/96 P 30,000 A 12.50
Common Stock 11/13/96 P 2,000 A 12.50
Common Stock 11/15/96 P 3,500 A 12.625
Common Stock 11/18/96 P 11,000 A 12.625
Common Stock 11/22/96 P 7,000 A 12.50
Common Stock 11/26/96 P 13,000 A 12.50
Common Stock 11/27/96 P 7,500 A 12.50
<CAPTION>
5. Amount of Securities
Beneficially Owned at 6. Ownership Form: 7. Nature of Indirect
End of Month Direct (D) or Indirect (I) Beneficial Ownership
(Instr. 3 and 4) (Instr. 4) (Instr. 4)
------------------------ -------------------------- --------------------------------------------------
<S> <C> <C>
-- I Director of Old World Industries, Inc.
-- I Director of Old World Industries, Inc
-- I Director of Old World Industries, Inc
-- I Director of Old World Industries, Inc
-- I Director of Old World Industries, Inc
-- I Director of Old World Industries, Inc
-- I Director of Old World Industries, Inc
513,000 I Director of Old World Industries, Inc
</TABLE>
Page 2 of 4
<PAGE> 3
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
5. Number of Derivative
Securities Acquired (A) or
2. Conversion or 4. Transaction Disposed of (D) (Instr. 3, 4,
Exercise Price of 3. Transaction Code (Instr. 8) and 5)
Derivative Date (Month/ --------------- -----------------------------
1. Title of Derivative Security (Instr. 3) Security Day/Year) Code | V (A) | (D)
- ------------------------------------------ ----------------- -------------- --------------- -----------------------------
<S> <C> <C> <C> <C> <C>
NOT APPLICABLE
9. Number of 10. Owner-
7. Title and Amount of Derivative ship
6. Date Exercisable Underlying Securities Securities Form of 11. Nature
and Expiration Date (Instr. 3 and 4) Benefici- Derivative of
(Month/Day/Year) ---------------------- 8. Price of ally Owned Security: Indirect
- ---------------------- | Amount Derivative at End Direct (D) or Beneficial
Date | Expira. | or Number Security of Month Indirect (I) Ownership
Exercisable | Date Title | of Shares (Instr. 5) (Instr. 4) (Instr. 4) (Instr. 4)
- ---------------------- ---------------------- ----------- ------------- -------------- -----------
NOT APPLICABLE
</TABLE>
Page 3 of 4
<PAGE> 4
Explanation of Responses:
None
Date: November 30, 1996 /s/ Mac M. Churchill
----------------- --------------------
Mac M. Churchill
** Signature of Reporting Person
**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 procedure.
Page 4 of 4
<PAGE> 5
Explanation of Responses:
None
Date: November 30, 1996
----------------- ------------------
Mac M. Churchill
** Signature of Reporting Person
**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 procedure.
Page 4 OF 4
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