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OMB Number 3235-0287
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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 to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b). (Print or Type Responses)
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1. Name and Address of Reporting Person*
Hensel Emil
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(Last) (First) (Middle)
2538 NW 64th Street
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(Street)
Boca Raton FL 33496
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Cross Country, Inc. (CCRN)
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3. IRS Identification Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Year
August 2002
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[X] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (Specify below)
Chief Financial Officer
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7. Individual or Joint/Group Filing (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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6.
4. 5. Owner-
Securities Acquired (A) Amount of ship
3. or Disposed of (D) Securities Form: 7.
2. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
Transaction Code -------------------------- Owned at End (D) or Indirect
1. Date (Instr. 8) (A) of Month Indirect Beneficial
Title of Security (Month/ ----------- Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock 8/22/02 X 7,000 A 7.75 51,059 D
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42,349 I By wife
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7,452 I By son (1)
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7,452 I By son (1)
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7,453 I By daugther
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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
5(b)(v).
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 control number.
(Over)
SEC 1474 (3-99)
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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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or 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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Employee Exercise 8/22/02 X 7,000 (2) 12/16/09 Common 7,000 7.75(3) 403,155 D
Stock Stock
Option
(right
to buy)
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Explanation of Responses:
(1) Mr. Hensel's two sons are adult and as a result, he disclaims beneficial
ownership of these shares.
(2) The option is subject to the vesting schedule set forth in the Amended and
Restated Cross Country, Inc. 1999 Equity Participation Plan. The option is
immediately exercisable as to 256,347 shares. The option will be exercisable as
to 307,617 shares as of December 16, 2002, 358,885 shares as of June 16, 2003
and 410,155 shares as of December 16, 2003. After this transaction, the option
is immediately exercisable as to 249,347 shares and the option will be
exercisable as to 300,617 shares as of December 16, 2002, 351,885 shares as of
June 16, 2003 and 403,155 shares as of December 16, 2003.
(3) Pursuant to the Amended and Restated Cross Country, Inc. 1999 Equity
Participation Plan, the first tranche of 73,396 shares will be exercisable at
$7.75 per share, the second tranche of 138,157 shares will be exercisable at
$11.62 per share, the third tranche of 138,157 shares will be exercisable at
$15.50 per share, the fourth tranche of 30,222 shares will be exercisable at
$19.37 per share and the remaining tranche of 30,223 shares will be exercisable
at $23.25 per share. After this transaction the first tranche will be reduced by
7,000 shares to 66,396 shares, which shares will be exercisable at $7.75 per
share and the remainder of the tranches will be exercisable in the amounts and
at the prices described above.
Emil Hensel
/s/ Emil Hensel 8/23/02
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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 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.