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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
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1. Name and Address of Reporting Person*
CB Capital Investors, LLC ("CBCI, LLC") (FN 1)
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(Last) (First) (Middle)
380 Madison Avenue, 12th Floor
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(Street)
New York, NY 10017
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
1/1/2000
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3. IRS Identification Number of Reporting Person, if an entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
The Pantry, Inc. ("PTRY")
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
|_| Director |X| 10% Owner
|_| Officer (give title below) |_| Other (specify below)
________________________________________
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6. If Amendment, Date of Original (Month/Day/Year)
06/08/99
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7. Individual or Joint/Group Filing (Check applicable line)
|_| Form filed by One Reporting Person
|X| Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4)
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<S> <C> <C> <C>
Common Stock 956,322 D
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</TABLE>
* If the Form is filed by more than one Reporting Person see instruction
5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Page 1 of 2
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FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
Explanation of Responses:
(1) Pursuant to an internal reorganization effective as of January 1, 2000, (i)
CB Capital Investors, LLC ("CBCI, LLC") became the successor to CB Capital
Investors, LP ("CBCI, LP"), (ii) CB Capital Investors, Inc. ("CBCI, Inc.")
became the managing member of CBCI, LLC, and Chase Capital Partners ("CCP")
became the manager, by delegation, of CBCI, LLC pursuant to a master advisory
agreement with CBCI, Inc. The internal reorganization changed CBCI, LP's name
and form of organization but did not alter the proportionate interests of its
ultimate security holders.
CB Capital Investors, LLC
** Signature of Reporting Person
By: Chase Capital Partners, as Manager
By: ____________________________
Title: _________________ of Chase Capital Partners 2/ /2000
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Date
** 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.
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<TABLE>
<CAPTION>
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Title of
Derivative
Date of Title and Securities and Ownership Nature of Disclaims
Name and Address Designated Event Issuer Name, Amount of Title and Form: Indirect Pecuniary
of Reporting Reporter(1) Requiring Ticker Security Amount of Direct (D) or Beneficial Interest
Person Statement or Trading Symbol Securities Indirect (I) Ownership
Underlying
Derivative
Securities
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
John R. Baron CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Mitchell J. Blutt CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Chris C. Behrens CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Arnold L. Chavkin CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Eric Green CB Capital January 1, The Pantry, Inc. Common N/A I See Yes
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY 100
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Michael R. Hannon CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Donald J. Hofmann CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Page 3 of 7
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Stephen P. Murray CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below
Capital Partners 956,322
380 Madison
Avenue 12th Floor
New York, NY
10017
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John M.B. CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
O'Connor Investors, LLC 2000 ("PTRY") Stock Note 2 below
C/o Chase 956,322
Capital Partners
380 Madison
Avenue 12th Floor
New York, NY
10017
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Susan L. Segal CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory Yes
c/o Chase Capital Investors, LLC 2000 ("PTRY") Stock Note 2 below
Partners 956,322
380 Madison
Avenue
12th Floor
New York, NY
10017
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Shahan D. CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
Soghikian Investors, LLC 2000 ("PTRY") Stock Note 2 below
c/o Chase 956,322
Capital
Partners
50 California
Street, Suite
2940
San Francisco,
CA 94111
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Jeffrey C. Walker CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below
Capital Partners 956,322
380 Madison
Avenue 12th Floor
New York, NY
10017
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Timothy J. Walsh CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below
Capital Partners 956,322
380 Madison
Avenue 12th Floor
New York, NY
10017
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Richard D. Waters CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory Yes
c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below
Capital Partners 956,322
380 Madison
Avenue 12th Floor
New York, NY
10017
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Damion E. Wicker CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Note 2 below
Capital Partners 956,322
380 Madison
Avenue 12th Floor
New York, NY
10017
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CCP European CB Capital January 1, The Pantry, Inc. Common N/A I See No
Principals, LLC Investors, LLC 2000 ("PTRY") Stock Explanatory
c/o Chase 956,322 Note 2 below
Capital Partners
380 Madison
Avenue 12th Floor
New York, NY
10017
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CCP Principals, CB Capital January 1, The Pantry, Inc. Common N/A I See No
LLC c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 2 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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Chase Capital CB Capital January 1, The Pantry, Inc. Common N/A I See No
Corporation Investors, LLC 2000 ("PTRY") Stock Explanatory
(f/k/a Chemical 956,322 Note 2 below
Capital
Corporation)
c/o Chase
Capital Partners
380 Madison
Avenue 12th Floor
New York, NY
10017
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The Chase CB Capital January 1, The Pantry, Inc. Common N/A I See No
Manhattan Investors, LLC 2000 ("PTRY") Stock Explanatory
Corporation 956,322 Note 3 below
270 Park Avenue
35th Floor
New York, NY
10017
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Chase Capital CB Capital January 1, The Pantry, Inc. Common N/A I See No
Partners Investors, LLC 2000 ("PTRY") Stock Explanatory
380 Madison 956,322 Note 4 below
Avenue 12th Floor
New York, NY
10017
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The Chase CB Capital January 1, The Pantry, Inc. Common N/A I See No
Manhattan Bank Investors, LLC 2000 ("PTRY") Stock Explanatory
270 Park Avenue 956,322 Note 5 below
35th Floor
New York, NY
10017
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David Ferguson CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 6 below
380 Madison
Avenue
12th Floor
New York, NY
10017
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I. Robert Greene CB Capital January 1, The Pantry, Inc. Common N/A I See Explanatory No
c/o Flatiron Investors, LLC 2000 ("PTRY") Stock Note 7 below
Partners 956,322
257 Park Avenue
South 12th Floor
New York, NY
10010
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Brian J. Richmand CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 8 below
380 Madison
Avenue
12th Floor
New York, NY
10017
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Jonas Steinmann CB Capital January 1, The Pantry, Inc. Common N/A I See No
c/o Chase Investors, LLC 2000 ("PTRY") Stock Explanatory
Capital Partners 956,322 Note 9 below
380 Madison
Avenue 12th Floor
New York, NY
10017
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</TABLE>
Explanatory Note:
1) The Designated Reporter is executing this report on behalf of all reporting
persons, each of whom has authorized it to do so.
2) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because the reporting person is a partner
of Chase Capital Partners ("CCP"), which is the manager, by delegation, of CBCI,
LLC, pursuant to an advisory agreement with CB Capital Investors, Inc. The
actual pro rata portion of such beneficial ownership that may be deemed to be
attributable to the reporting person is not readily determinable because it is
subject to several variables, including the internal rate of return and vesting
of interests within CCP and CBCI, LLC.
3) The amount shown in Table I represents beneficial ownership of the Issuer's
equity securities by CBCI, LLC, a portion of which may be deemed attributable to
the reporting person because it is (i) the sole stockholder of Chase Capital
Corporation, which is a general partner of CCP, the non-managing member of CBCI,
LLC and manager, by delegation of CBCI, LLC, pursuant to an advisory agreement
with its managing member, and (ii) the sole stockholder of The Chase Manhattan
Bank, the sole stockholder of CB Capital Investors, Inc. (the managing member of
CBCI, LLC). The actual pro rata portion of such beneficial ownership that may be
attributable to the reporting person is not readily determinable because it is
subject to several variables, including the internal rate of return and vesting
of interests within CCP and CBCI, LLC.
4) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because it is the non-managing member of
CBCI, LLC and the manager, by delegation of CBCI, LLC, pursuant to an advisory
agreement with the managing member of CBCI, LLC. The actual pro rata portion of
such beneficial ownership that may be deemed to be attributable to the reporting
person is not readily determinable because it is subject to several variables,
including the internal rate of return and vesting of interests within CCP and
CBCI, LLC.
5) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because it is the sole stockholder of the
managing member of CBCI, LLC.
6) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the non-managing member of CBCI, LLC and the manager, by delegation of CBCI,
LLC, until June 1, 1997. The actual pro rata portion of such beneficial
ownership that may be deemed to be attributable to the reporting person is not
readily determinable because it is subject to several variables, including the
internal rate of return and vesting within CCP and CBCI, LLC.
7) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the non-managing member of CBCI, LLC and the manager, by delegation of CBCI,
LLC, until May 31, 1999. The actual pro rata portion of such beneficial
ownership that may be deemed to be attributable to the reporting person is not
readily determinable because it is subject to several variables, including the
internal rate of return and vesting within CCP and CBCI, LLC.
Page 6 of 7
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8) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the non-managing member of CBCI, LLC and the manager, by delegation of CBCI,
LLC, until December 31, 1999. The actual pro rata portion of such beneficial
ownership that may be deemed to be attributable to the reporting person is not
readily determinable because it is subject to several variables, including the
internal rate of return and vesting within CCP and CBCI, LLC.
9) The amount shown in Table I represents the beneficial ownership of the
Issuer's equity securities by CBCI, LLC, a portion of which may be deemed
attributable to the reporting person because he was a general partner of CCP,
the non-managing member of CBCI, LLC and the manager, by delegation of CBCI,
LLC, until July 1, 1999. The actual pro rata portion of such beneficial
ownership that may be deemed to be attributable to the reporting person is not
readily determinable because it is subject to several variables, including the
internal rate of return and vesting within CCP and CBCI, LLC.
Page 7 of 7