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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 | ||||||||
Options (Right to Buy) | $ 38.69 | 12/02/2004 | M(2) | 5,300 (1) | 02/23/1999 | 02/23/2008 | Common Stock | 5,300 (1) | $ 38.69 | 94,700 (1) | D | ||||
Options (Right to Buy) | $ 38.69 | 12/03/2004 | M(2) | 21,700 (1) | 02/23/1999 | 02/23/2008 | Common Stock | 21,700 (1) | $ 38.69 | 73,000 (1) | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HAYS THOMAS C FORTUNE BRANDS, INC. 300 TOWER PARKWAY LINCOLNSHIRE, IL 60069 |
X |
Russell W. Hahn, Attorney-in-Fact for Thomas C. Hays | 12/06/2004 | |
**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) | Attached to each share of common stock is one Preferred Share Purchase Right that is not presently transferable from the common stock. |
(2) | Reflects the exercise of options granted under the issuer's Long-Term Incentive Plans. |
(3) | The number of shares reported as held by the Fortune Brands, Inc. Retirement Savings Plan Trust represents the undersigned's proportional beneficial interest in the common stock held in the Trust as of December 2, 2004. |
Remarks: On December 2, 2004 and December 3, 2004, Mr. Hays performed cashless exercises of options granted issued to him under the issuer's Long-Term Incentive Plans. Specifically, on December 2, 2004, Mr. Hays purchaed and then subsequently sold 5,300 shares of the issuer's common stock. On December 3, 2004, Mr. Hays purchased and subsequently sold 21,700 shares of the issuer's common stock. After these transactions, Mr. Hays indirectly owns 52,352 shares of the issuer's common stock through the revocable trust described above. In addition, Mr. Hays is deemed to have indirect beneficial ownership of 9,907 shares held in various trusts for the benefit of family members; however, he disclaims beneficial ownership of these shares. Mr. Hays also owns options to purchase 260,500 shares of the issuer's common stock and holds 4,063 shares through his participation in the Fortune Brands Retirement Savings Plan. |