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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 | ||||||||
Restricted Stock Units | (1) | 08/12/2009 | G | V | 30,742 | (1) | (1) | Common Stock | 30,742 | $ 0 | 30,742 | D (1) | |||
Restricted Stock Units | (1) | 08/12/2009 | G | V | 30,742 | (1) | (1) | Common Stock | 30,742 | $ 0 | 30,742 | I | Trust (1) | ||
Restricted Stock Units | (2) | 10/15/2009 | A | 211 (3) | (2) | (2) | Common Stock | 211 | $ 27.58 | 30,953 | I | Trust (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
CROGHAN JOHN W 200 NORTH WACKER DRIVE ROOM 4120 CHICAGO, IL 60606 |
X |
/s/ Eileen B. Schuler Attorney in Fact | 10/19/2009 | |
**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) | Previously reported restricted stock units were transferred to JWC Trust UA dated 12/28/82 of which the reporting person is the Trustee. |
(2) | Based on 1 on 1 conversion. Dividends paid on the restricted stock units awarded under the Republic Services, Inc. 2007 Stock Incentive Plan. Restricted Stock Units are held by JWC Trust as disclosed in Item 1. |
(3) | Initial Form 4 filing dated 10/19/2009 inadvertently showed the 211 Restricted Stock Units as being disposed rather than acquired through dividend equivalents. The total 30,953 Restricted Stock Units owned is correctly stated. |
Remarks: See attached footnote page. |