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Previous: LOEWEN GROUP INC, 4, 2000-02-04 |
Next: LOEWEN GROUP INC, 5, 2000-02-04 |
<TABLE>
<CAPTION>
- ---------------- U.S. SECURITIES AND EXCHANGE COMMISSION ----------------------------
|F O R M 5| Washington, D.C. 20549 | OMB APPROVAL |
- ---------------- |--------------------------|
Check this box if ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0362|
[ ] no longer Subject |Expires: September 30,1998|
to Section 16. |Estimated ave. burden |
|hours per response.....1.0|
[ ] Form 3 Holdings Rep. 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
[ ] Form 4 Trans. Rep. Section 30(f) of the Investment Company Act 1940
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Name and Address of Reporting Person* |2.Issuer Name and Ticker or Trading Symbol |6.Relationship of Reporting Person to |
| | | Issuer (Check all Applicable) |
|RYAN Roger C. |The Loewen Group Inc. | |
| | (lwn) | |
| | | Director 10% Owner |
|----------------------------------------|------------------------------------------------|--- --- |
| (Last) (First) (MI)|3.IRS or Soc. Sec. No. |4.Statement for Month/ | X Officer Other |
| | of Reporting Person | Year |---(give title below) ---(Specify below)|
| #17088 SE 58th Street | (Voluntary) | | |
| | | 12/31/1999 | |
| | | | Vice President, Taxation |
|----------------------------------------| |------------------------|----------------------------------------|
| (Street) | |5.If Amendment, Date of |7. Individual or Joint/Group Filing |
| | | Original (Month/Year) | (Check Applicable Line) |
| | | | |
|Bellevue WA 98006 | | | X Form filed by One Reporting Person |
| | | |--- |
| | | | Form filed by More than One |
| | | |--- Reporting Person |
|----------------------------------------------------------------------------------------------------------------------------------|
| (City) (State) (Zip) |
| TABLE I - Non-Derivative Securities Acquired, Disposed of or Beneficially Owned |
|----------------------------------------------------------------------------------------------------------------------------------|
|1.Title of Security |2.Transac- |3.Trans. |4.Security Acquired (A) or |5.Amount of |6. |7.Nature of Indirect|
| (Instr. 3) | tion Date | Code | Disposed of (D) | Securities |Own.| Beneficial |
| |(Mon/Day/Yr)|(Instr.8)| (Instr. 3, 4 & 5) | Beneficially |Form| Ownership |
| | | | | Owned at End of|(D) | (Instr. 4) |
| | | |-------------------------------| Issuer's |or | |
| | | | |(A) | | Fiscal Year |(I) | |
| | | | Amount |(D) | Price | (Instr. 3 & 4) | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |
| | | | | | | | | |
| | | | | | | | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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- ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class securities owned directly or indirectly. SEC 2270 (7-96)
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
PAGE: 1 OF 2
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<CAPTION>
FORM 5 (continued) TABLE II - Derivative Securities Acquired, Disposed of, Beneficially Owned
(e.g., puts, calls, warrants, options, convertible security)
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Title of|2.Conver-|3. |4.Tran- |5.Number of |6.Date |7.Title and Amount |8.Price of|9.Number |10. |11.Nature |
|Derivative|sion or |Trans| saction| Derivative |Exercisable| of Underlying |Derivative| of |Own.| of |
|Security |Exercise |Date | Code | Securities |and | Securities |Security |Derivative|Form|Indirect |
|(Instr. 3)|Price of |(Mon/|(Instr.8)| Acquired (A) or |Expiration | (Instr. 3 & 4) |(Instr. 5)|Securities|of |Beneficial|
| |Deriva- | Day/| | Disposed of (D) |Date | | |Benefi- |Deri|Ownership |
| |tive |Year)| | (Instr. 3, 4 & 5) |(Month/Day/| | |cially |Sec.|(Instr. 4)|
| |Security | | | | Year) | | |Owned at |Dir.| |
| | | | | |-----------|---------------------| |End of |(D) | |
| | | | | | | | |Amount or | |Year |or | |
| | | | |---------------------|Date |Exp. | Title |Number of | |(Instr. 4)|Ind.| |
| | | | | (A) | (D) |Exbl.|Date | |Shares | | |(I) | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |
|TLGI Fund | $.4375|12/31| I | 448.87| | | |Common Sto| 448.87| $0.4375 | 448.87| I |By 401(k) |
| | | 1999| | | | | |ck | | | | |Plan |
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| | | | | | | (01)| (01)| | | | | | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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- ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses:
(01) Under the Loewen Group International, Inc. 401(k) Retirement Plan, the reporting person invests in the TLGI Fund. The T
LGI Fund invests primarily in Common shares, but also maintains cash reserves. The TLGI Fund operates as a pooled fu
nd. No Common shares are allocated to individual participants' accounts, and distributions are made entirely in cash.
Based on the reporting person's investment in the TLGI Fund, and the Common share price at 12/31/99.
**Intentional misstatements or omissions of facts constitute Federal /s/Bradley D. Stam 02/04/2000
Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------------------ ----------
**Signature of Reporting Person Date
Note: File three copies of this form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for procedure. SEC 2270 (7-96)
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 OMD Number
RYAN, Roger C. The Loewen Group Inc. 12/31/1999 PAGE: 2 OF 2
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