Form 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |
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OMB Number: 3235-0362 |
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Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See instructions 1(b). |
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[ ] | Form 3 Holdings Reported | ||
[X] | Form 4 Transactions Reported |
1. Name and Address of Reporting
Person*
Lanier, II J. Smith |
2. Issuer Name and Ticker
or Trading Symbol
Interface, Inc. (IFSIA) |
6. Relationship of Reporting Person(s) to Issuer
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(Last) (First) (Middle)
2859 Paces Ferry Road, Suite 2000 |
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Year 12/29/02 | ||||||||
(Street)
Atlanta, Georgia 30339 |
5. If Amendment, Date of Original (Month/Year)
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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 | ||||||||
(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||
1. Title of Security (Instr. 3) |
2. Transaction Date (Month/Day/Year) |
2A. Deemed Execution Date, if any (Month/Day/Year) |
3. Transaction Code (Instr. 8) |
4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned at the end of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) |
7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount |
(A) or (D) |
Price | ||||||
Class A Common Stock | 10-17-02 | 4(1) |
47,000 |
D | ||||||
Class A Common Stock |
4(2) |
400 |
I |
By Wife(3) | ||||||
Class B Common Stock |
140,644 |
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Class B Common Stock |
4(2) |
157,004 |
I |
By Wife(3) | ||||||
* If the form is filed by more than one reporting person, see instruction 4(b)(v).
Form 5 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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. Trans- action 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 |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Year (Instr. 4) |
10. Ownership of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) |
(D) |
Date |
Expiration |
Title |
Amount or Number of Shares |
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Explanation of
Responses:
(1) On the reporting person's Form 4 filed on October 21, 2002, the reported amount of securities directly owned following the reported transaction failed to account for the effect of the 2-for-1 stock split in 1998. The correct amount is 47,000 shares. (2) The reporting person's wife has owned such shares at all times since December 1987, when such shares were last reported by the reporting person. (3) The reporting person disclaims beneficial ownership of the shares held by his wife. |
/s/ J. Smith Lanier, II J. Smith Lanier, II **Signature of Reporting Person |
2-04-03
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** | 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 |