FORM 5
[ ] Check this box if no longer
subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). [ ]Form 3 Holdings Reported
[ ]Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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 |
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1. Name and Address of Reporting Person*
Goldsberry, Ronald E.
(Last) (First) (Middle)
3290 Chestnut Drive
(Street)
Bloomfield Hills, MI 48302
(City) (State) (Zip)
|
2. Issuer Name and Ticker or Trading Symbol UnumProvident Corporation UNM
3. I.R.S. Identification
Number of Reporting Person, if an entity (voluntary) |
4. Statement for (Month/Year) December 2002
5. If Amendment,
Date of Original (Month/Year) |
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable) X Director
10% Owner
Officer
Other
Officer/Other
Description
7. Individual or Joint/Group
Filing (Check Applicable Line) X Individual Filing
Joint/Group Filing
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1. Title of Security (Instr. 3) |
2. Transaction Date
(Month/Day/Year) |
3. Transaction
Code (Instr. 8) |
4. Securities Acquired (A) or Disposed (D) Of (Instr. 3, 4, and 5) Amount | A/D | Price
|
5. Amount of
Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Owner-
ship Form: Direct(D) or Indirect (I) (Instr. 4) |
7. Nature of
Indirect Beneficial Ownership (Instr. 4) |
Common Stock
|
|
|
|
19,082.00 (1) |
D
|
|
Common Stock
|
|
|
|
1,800.00 |
I
|
By Family Limited Partnership
|
If the form is filed by more than one reporting person, see instruction 4(b)(v).
(over)
SEC 2270 (3-99) |
Goldsberry, Ronald E. - December 2002 |
Form 5 (continued) |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
|
1. Title of Derivative Security
(Instr. 3) |
2. Conver-
sion or Exercise Price of Deri- vative Security |
3. Transaction
Date (Month/ Day/ Year) |
4. Transaction
Code |
5. Number of Derivative Securities Acquired (A) or Disposed (D) Of (Instr. 3,4 and 5) |
6. Date Exercisable(DE) and
Expiration Date(ED) (Month/Day/Year) (DE) | (ED)
|
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 at End of Year (Instr.4) |
10. Owner- ship Form of Deriv- ative Security: Direct (D) or Indirect (I) |
11. Nature of Indirect Beneficial Ownership (Instr.4) |
Unum Corp Deferred Comp Plan Dividend |
1 for 1 | 02/15/2002 |
A
|
(A) 37.00 |
@ termination | N/A
|
Common Stock - 37.00 | $28.90 |
|
D
|
|
Unum Corp Deferred Comp Plan Dividend |
1 for 1 | 05/17/2002 |
A
|
(A) 42.00 |
@ termination | N/A
|
Common Stock - 42.00 | $25.77 |
|
D
|
|
Unum Corp Deferred Comp Plan Dividend |
1 for 1 | 08/16/2002 |
A
|
(A) 48.00 |
@ termination | N/A
|
Common Stock - 48.00 | $22.29 | 7,404.26 |
D
|
|
** 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. |
By: Susan N. Roth on behalf of ________________________________ __________________ ** Signature of Reporting Person Date Power of Attorney Page 2
SEC 2270 (3-99) |
Goldsberry, Ronald E. - December 2002 |
Form 5 (continued) |
FOOTNOTE Descriptions for UnumProvident Corporation UNM Form 5 - December 2002 Ronald E. Goldsberry
3290 Chestnut Drive Bloomfield Hills, MI 48302 Explanation of responses: (1) Includes 11,082 deferred share rights. |
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