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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 | ||||||||
Performance Shares (3) | $ 0 (4) | 02/28/2005 | M | 20,000 | 12/31/2004 | 12/31/2004 | Common Shares | 20,000 | $ 0 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DAVIS MONTY L 6316 WINDFERN HOUSTON, TX 77040 |
COO |
/s/ John D. Denson, Attorney-in-fact | 03/01/2005 | |
**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) | Includes 16,492 restricted shares granted pursuant to an Executive Matching Agreement. The restricted shares will generally vest three years from the date of grant assuming continued employment, continued ownership of the underlying common shares upon which the grant was based and certain other conditions. |
(2) | These Common Shares were acquired pursuant to the Core Laboratories, Inc. Profit Sharing and Retirement Plan (the "401(k) Plan") or pursuant to the Core Laboratories, Inc. Deferred Compensation Plan (the "Deferred Comp Plan"), as the case may be, on various dates at various prices per share. The number of Common Shares shown in column 5 of Table 1 is based on an allocation of the aggregate number of Common Shares acquired by the trustee under the 401(k) Plan or the Deferred Comp Plan, as the case may be, for the benefit of the plan participants who elected to make intra-plan transfers into the Common Share fund under the 401(k) Plan or the Deferred Comp Plan, as the case may be, at approximately the same time (pro rata, based on the dollar amount of each such participant's intra-plan transfer into the Common Share fund, rounding up or down to the nearest whole share). |
(3) | Includes tax withholding right. |
(4) | 1-for-1 |