Form 4 |
UNITED STATES SECURITIES AND
EXCHANGE COMMISSION STATEMENT OF CHANGES IN
BENEFICIAL OWNERSHIP |
OMB APPROVAL |
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OMB Number: 3235-0287 |
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Expires: January 31, 2005 |
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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). |
Estimated average burden |
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1. Name and Address of
Reporting Person* |
2. Issuer Name and Ticker
or Trading Symbol |
6. Relationship of
Reporting Person(s) to Issuer President & Chief Executive Officer |
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(Last) (First) (Middle)
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3. I.R.S. Identification Number of Reporting Person, if an entity |
4. Statement for
Month/Day/Year |
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(Street)
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5. If Amendment, Date of
Original (Month/Day/Year) |
7. Individual or
Joint/Group Filing |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security |
2. Transaction Date |
2A. Deemed Execution |
3. Transaction |
4. Securities Acquired (A) |
5. Amount of Securities |
6. Ownership Form: |
7. Nature of Indirect |
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Code |
V |
Amount |
(A) |
Price |
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Collins Industries, Inc. Common Stock |
02/28/2003 |
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A |
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70,000 |
A |
$3.600 |
561,997 |
D |
Self |
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Reminder: Report on a
separate line for each class of securities beneficially owned directly or
indirectly. |
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Potential persons who are
to respond to the collection of information contained in this form are not |
(Over) |
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Table II - Derivative
Securities Acquired, Disposed of, or Beneficially Owned |
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1. |
2. |
3. |
3A. |
4. |
5. |
6. |
7. |
8. |
9. |
10. |
11. |
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Code |
V |
(A) |
(D) |
Date |
Expiration |
Title |
Amount |
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Explanation of Responses: |
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** |
Intentional misstatements
or omissions of facts constitute Federal Criminal Violations. |
/s/ Larry W. Sayre, Attorney in Fact for Donald Lynn Collins under a Limited Power of Attorney dated December 4, 1997 **Signature of Reporting Person |
03/04/03
Date |
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Note: |
File three copies of this
Form, one of which must be manually signed. |
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Potential persons who are
to respond to the collection of information contained in this form are not |
Page 2 |
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