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OMB APPROVAL
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OMB Number 3235-0362
Expires: September 30, 1998
Estimated average burden
hours per response ....... 1.0
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
ANNUAL 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).
[ ] Form 3 Holdings Reported
[ ] Form 4 Transactions Reported
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1. Name and Address of Reporting Person
Koch, C. James
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(Last) (First) (Middle)
c/o Boston Beer Company, Inc., 75 Arlington Street
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(Street)
Boston, Massachusetts 02116
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
The Boston Beer Company, Inc.
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
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5. If Amendment, Date of Original (Month/Year)
December 1999
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[X ] Director [X ] 10% Owner
[X ] Officer (give title below) [ ] Other (specify below)
President and CEO
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7. Individual or Joint/Group Reporting
(Check Applicable LIne)
[X ] Form Filed by One Reporting Person
[ ] Form Filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<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)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Class A Common Stock 1,472 I Note 1
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Class A Common Stock 867,729 D
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Class B Common Stock 4,107,355 D
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Class A Common Stock 332,835 I Note 2
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Class A Common Stock 28,800 I Note 3
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly
<PAGE>
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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<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)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Restricted Stock Cur Class A
Purchase (Note 4) 4.74538 l/l/98 A 2,807 rently 1/1/03 Common 2,807 4.7438 2,245 D
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Stock Option (Right Cur- Class A
to Buy) 0.01 12/31/94 A 2,927 rently 12/31/04 Common 2,927 0.01 2,927 D
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Restricted Stock Cur- Class A
Purchase (Note 4) 5.0625 1/1/99 A 2,237 rently 1/1/09 Common 2,237 5.0625 2,237 D
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Stock Option (Right Note Class A
to Buy) 8.4375 1/1/99 A 3,000 1/1/00 5,9 Common 3,000 8.4375 3,000 D
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Stock Option (Right Note Class A
to Buy) 11.2219 1/1/99 A 3,750 Note 6 5,9 Common 3,750 11.2219 3,750 D
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Stock Option (Right Note Class A
to Buy) 14.0906 1/1/99 A 3,750 Note 7 5,9 Common 3,750 14.0906 3,750 D
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Stock Option (Right Note Class A
to Buy) 16.875 1/1/99 A 4,500 Note 8 5,9 Common 4,500 16.875 4,500 D
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</TABLE>
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Explanation of Responses:
Note 1: Shares held by the spouse of the Reporting Person.
Note 2: Shares held by a trust in which the children of the Reporting Person
have a pecuniary Interest.
Note 3: Shares held by Reporting Person as custodian for benefit of
Reporting Person's children.
Note 4: Restricted stock purchase pursuant to the Investment Share
Program under the issuer's Employee Equity Incentive Plan.
Note 5: Options remain exercisable for so long as the Reporting Person remains
employed by the Company or an affiliate of the Company.
Note 6: 3,000 of these Shares vest as of 1/1/01 and 750 of these Shares vest
as of 1/1/02.
Note 7: 2,250 of these Shares vest as of 1/1/02 and 1,500 of these Shares vest
as of 1/1/03.
Note 8: 1,500 of these Shares vest as of 1/1/03 and 3,000 of these Shares vest
as of 1/1/04.
Note 9: Options become immediately exercisable in full in the event the
Reporting Person and/or members of his family cease to control a
majority of the Company's issued and outstanding Class B Common
Stock.
/s/ C. James Koch February 25, 2000
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**Signature of Reporting Person 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 procedures.
