FORM 4 |
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION |
OMB APPROVAL |
X Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
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(h) of the Investment Company Act of 1940 |
OMB
Number: 3235-0287 Filed By |
1. Name and Address of Reporting Person* Rollins Holding Company, Inc. |
2. Issuer Name and
Ticker or Trading Symbol |
6. Relationship of
Reporting Person(s) Former 10% Owner |
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(Last) (First) (Middle) c/o LOR, Inc. |
3. I.R.S. Identification
Number
|
4. Statement for Month/Day/Year 04/28/2003 |
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(Street) Atlanta, GA 30324 |
5. If Amendment, Date of Original (Month/Day/Year) |
7. Individual
or Joint/Group Filing (Check Applicable Line) Form filed by One Reporting Person X Form filed by More than One Reporting Person |
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(City) (State) (Zip) |
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security |
2. Trans- |
2A. Deemed |
3. Trans- |
4. Securities Acquired
(A) or Disposed of (D) |
5. Amount of |
6. Owner- |
7. Nature of Indirect
|
|||
Code |
V |
Amount |
(A) |
Price |
||||||
Common Stock |
4/28/03 |
|
D |
|
D |
|
0 |
D |
|
Reminder:
Report on a separate line for each class of securities beneficially owned
directly or indirectly. * If the form is filed by more than one reporting person, see Instruction 4(b)(v). 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 |
FORM 4 (continued) |
Table II -
Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Derivative
Security |
2. Conver- |
3. Trans- |
3A. Deemed Execution Date, if any (Month/ Day/ Year) |
4. Trans- |
5. Number of Derivative
Securities Acquired (A) or Disposed of (D) |
6. Date Exercisable |
7. Title and Amount
of Underlying Securities |
8. Price of Derivative
Security |
9. Number of |
10. Owner- |
11. Nature of Indirect
Beneficial Ownership |
||||
Code |
V |
(A) |
(D) |
Date Exer-cisable |
Expira- |
Title |
Amount or Number
of |
Explanation of Responses: (1) These shares were previously held through RFPS Investments I, L.P. ("RFPS Investments"). The reporting persons on this Form 4 were limited partners of RFPS Investments. On April 28, 2003, RFPS Investments contributed all of its shares to RFPS Management Company I, L.P. ("RFPS Management") and RFPS Investments became a limited partner. After the transfer, the reporting persons on this Form 4 no longer exercise control over the voting or disposition of the shares.
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By: /s/ Glenn P. Grove, Jr. Rollins Holding Company, Inc. by Glenn P. Grove, Jr., Attorney-in-Fact **Signature of Reporting Person |
April 28, 2003 Date |
**Intentional misstatements
or omissions of facts constitute Federal Criminal Violations. Note: File three
copies of this Form, one of which must be manually signed. 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 Number.
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Joint Filer Information Name: Grace C. Rollins Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: GRACE C. ROLLINS /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-FactJoint Filer Information Name: RWR Management Company, LLC Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: RWR MANAGEMENT COMPANY, LLC /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: RRR Grandchildren's Custodial Partnership I, L.P. Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: RRR GRANDCHILDREN'S CUSTODIAL PARTNERSHIP I, L.P. /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: JR Partnership, L.P. Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: JR PARTNERSHIP, L. P. /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: JPR Investment Partnership, L.P. Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: JPR INVESTMENT PARTNERSHIP, L. P. /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: Richard R. Rollins, Jr. Grantor Trust Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: THE RICHARD R. ROLLINS, JR. GRANTOR TRUST U/Agreement dated February 27, 2001 /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: The Gary W. Rollins Trust Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: THE GARY W. ROLLINS TRUST U/Agreement dated December 30, 1976 /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: RCTLOR, LLC Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: RCTLOR, LLC /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: 1997 RRR Grandchildren's Partnership, L.P. Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: 1997 RRR GRANDCHILDREN'S PARTNERSHIP, L.P. /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: MRLT Partners, L.P. Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: MRLT PARTNERS, L.P. /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: Pamela Renee Rollins Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: PAMELA RENEE ROLLINS /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: Timothy Curtis Rollins Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: TIMOTHY CURTIS ROLLINS /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: Amy Rollins Kreisler Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: AMY ROLLINS KREISLER /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact Joint Filer Information Name: Nancy Rollins Griffith Address: c/o LOR, Inc. 2170 Piedmont Road, N.E. Atlanta, GA 30324 Designated Filer: Rollins Holding Company, Inc. Issuer & Ticker Symbol: Rollins, Inc. (ROL) Date of Event Requiring Statement: 4/28/03 Signature: NANCY ROLLINS GRIFFITH /s/ Glenn P. Grove, Jr. ---------------------------------------- By: Glenn P. Grove, Jr., Attorney-In-Fact 1574979