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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BASHAM ROBERT DANKER C/O OUTBACK STEAKHOUSE, INC. 2202 N. WEST SHORE BLVD., 5TH FLOOR TAMPA, FL 33607 |
X | COO |
/s/ Joseph J. Kadow, Attorney-in-Fact | 02/25/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | Owned by RDB Equities, Limited Partnership, a Nevada limited partnership ("LP"). |
(2) | Owned by the Robert D. Basham Irrevocable Trust Agreement of 2004, dated December 15, 2004 ("Irrevocable Trust") of which Joseph J. Kadow is the sole Trustee and Robert D. Basham is the sole beneficiary. The reporting person received 600,000 shares in a non-liquidating distribution from the Irrevocable Trust. These shares were previously reported as benefically owned by the reporting person indirectly through the Irrevocable Trust. The foregoing transaction is exempt from Section 16 pursuant to Rule 16a-13 as a change in form of beneficial ownership. These shares were subsequently transferred by the reporting person pursuant to that certain Martial Settlement Agreement dated January 3, 2005 as a disposition of marital assets. |
(3) | On February 22, 2005, Mr. Kadow, as the soleTrustee of the Irrevocable Trust, distributed to the Robert D. Basham Revocable Trust Agreement of 1992, dated September 4, 1992 ("Revocable Trust"), wherein the reporting person is the sole Trustee and beneficiary of the Revocable Trust, 1,491,326 shares of the Company's stock. The reporting person continues to report beneficial ownership of all of the common stock that was held by the Irrevocable Trust. The foregoing transaction is exempt from Section 16 pursuant to Rule 16a-13 as a change in form of beneficial ownership. The shares are now reported as owned by the Revocable Trust as reflected in Table 1. |
(4) | Not applicable. |