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Previous: TELE COMMUNICATIONS INC /CO/, SC 13D/A, 1998-09-09 |
Next: CITICORP LIFE VARIABLE ANNUITY SEPARATE ACCOUNT, N-30B-2, 1998-09-09 |
FORM 4
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
OMB APPROVAL
-----------------
OMB Number 3235-0287
Expires: September 30, 1998
Estimated average burden
hours per response .....................0.5
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
|_| Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. See Instruction 1(b).
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
(Print or Type Responses)
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1. Name and Address of
Reporting Person 2. Issuer Name and Ticker or Trading Symbol
ASV, Inc. (ASVI)
Dahl James H.
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for
Number of Reporting Month/Year
Person (Voluntary)
August 1998
1200 Riverplace Blvd., Suite 920
(Street) 5. If Amendment,
Date of Original
(Month/Year)
Jacksonville FL 32207
(City) (State) (Zip)
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6. Relationship of 7. Individual or Joint/Group Filing (Check
Reporting Person Applicable Line)
to Issuer
(Check all applicable)
X Form filed by One Reporting Person
X Direct X 10% Owner ___ Form filed by More than One
____ Officer (give _____ Other (specify Reporting Person
title below)
below)
____________________________________
<PAGE>
<TABLE>
<CAPTION>
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1. Title of 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
Security action action or Disposed of (D) Securities Form: Indirect
(Instr. 3) Date Code (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial
(Month/ (Instr. 8) Owned at End or Indirect Ownership
Day/ of Month (I) (Instr. 4)
See Note 1 Year) (Instr. 3 and (Instr. 4)
4)
---------------------------------------------
(A) or
Code V Amount (D) Price
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
By Trust
Common Stock 77,550 I FBO Son
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By Trust
Common Stock 78,150 I FBO Daughter
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By Rock Creek
Common Stock 444,900 I Partners, Ltd.
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By Spouse's
Common Stock J 4,500 D Note 2 I IRA
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TOTAL 600,600
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
4(b)(v).
(Over)
SEC 1474 (7/96)
<PAGE>
<TABLE>
<CAPTION>
FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date
Security sion or action action Derivative Exercisable and
(Instr. 3) Exercise Date Code Securities Expiration Date
Price of (Month/ (Instr. 8) Acquired (A) (Month/Day/
Derivative Day/ or Disposed of Year)
Security Year) (D)
(Instr. 3, 4
and 5)
-----------------------
Date Expira-
Exer- tion Date
cisable
--------------------------------------
Code V (A) (D)
- ---------------------------------------------------------------------------------------------------------------------
<S> <C> <C> <C> <C> <C> <C> <C> <C>
Common Stock Options $12.11 12/21/97
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Common Stock Options $12.11 12/21/98
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Common Stock Options $12.11 12/21/99
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Common Stock Options $12.11 12/21/00
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Warrants $3.90 5/3/96 8/17/99
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Warrants $3.90 6/20/96 8/17/99
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Convertible Subordinated $16.50 10/8/96 10/15/06
Debenture
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Common Stock Options $18.33 12/12/98 12/12/02
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Common Stock Options $18.33 12/12/99 12/12/02
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Common Stock Options $18.33 12/12/00 12/12/02
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Common Stock Options $18.33 12/12/01 12/12/02
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<CAPTION>
FORM 4 (continued)
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7. Title and Amount 8. Price 9. Number 10. Ownership 11. Nature
of Underlying of Deriv- of Form of of In-direct
Securities ative Derivative Derivative Bene-ficial
(Instr. 3 and 4) Security Securities Security; Owner-
(Instr. 5) Beneficial Direct (D) ship
-ly Owned or Indirect (Instr. 4)
at End of (I)
Month (Instr. 4)
(Instr. 4)
- -----------------------
Title Amount or
Number of
Shares
<S> <C> <C> <C> <C> <C>
- --------------------------------------------------------------------------------------
Common 2,812 1 D
Stock
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Common 2,812 1 D
Stock
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Common 2,812 1 D
Stock
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Common 2,812 1 D
Stock
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Common 180,000 180,000 I By Rock Creek
Stock Partners, Ltd.
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Common 22,500 22,500 D
Stock
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Common 136,363 1 I By Rock Creek
Stock Partners, Ltd.
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Common 3,758 1 D
Stock
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Common 3,758 1 D
Stock
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Common 3,758 1 D
Stock
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Common 3,758 1 D
Stock
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</TABLE>
Explanation of Responses
Note 1: All share and price information has been adjusted to give
effect to a 3-for-2 stock split effective May 15, 1998.
Note 2: Shares owned by an IRA account for Mrs. Georgia Dahl are no
longer attributed to Mr. Dahl as Mr. Dahl and Georgia Dahl no
longer reside in the same household.
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
August 31, 1998
** 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.
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 OMB Number.
Page 2
SEC 1474 (7/96)
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