UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Option to Purchase Common Stock (1) | 12/10/1999 | 12/10/2009 | Option to Purchase Common Stock | 11,600 | $ 9.875 | D | Â |
Stock Appreciation Rights | 11/22/2002 | 11/22/2012 | Stock Appreciation Rights | 18,450 | $ 3.15 | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Mills Keith C/O KATY INDUSTRIES, INC. 765 STRAITS TURNPIKE, SUITE 2000 MIDDLEBURY, CT 06762 |
 |  |  VP - International Operations |  |
/s/ Michael C. Paul | 09/22/2005 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | The exercisable date, conversion price, and expiration date on the stock options reflect information from the most recent grant date. The Reporting Person has received stock options from 1995 to 1999 with conversion prices ranging from $9.875 to $19.56. |