FORM 4 |
UNITED STATES SECURITIES
AND EXCHANGE COMMISSION |
OMB APPROVAL |
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 Romeo & Dye's Instant Form 4 Filer |
1. Name and Address of Reporting Person* PIGOTT JAMES CALVIN |
2. Issuer Name and
Ticker or Trading Symbol |
6. Relationship of
Reporting Person(s)
|
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(Last) (First) (Middle) 1405 42nd Avenue East |
3. I.R.S. Identification
Number
|
4. Statement for Month/Day/Year 12/4/2002 |
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(Street) Seattle, WA 98112 |
5. If Amendment, Date of Original (Month/Day/Year) |
7. Individual
or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting Person 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 |
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COMMON STOCK |
12/04/02 |
|
G |
|
680 |
D |
|
3,382,276(1) |
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) On April 30, 2002 PACCAR declared a stock dividend, payable to all holders of record of common stock on May 10, 2002, of one share of common stock for every two shares of common stock. As a result, the reporting person received 1, 127,652 shares of PACCAR common stock on May 28, 2002. |
By: /s/ James C. Pigott by Janice D'Amato POA **Signature of Reporting Person |
December 5, 2002 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.
|
POWER OF ATTORNEY I, James Calvin Pigott, hereby appoint and constitute G. Glen Morie and Janice M. D'Amato, acting individually, my true and lawful attorney-in-fact with full power to sign for me and in my name a Statement of Changes of Beneficial Ownership of Securities issued by PACCAR Inc on Form 4 and Form 5 to be filed with the Securities and Exchange Commission under the Securities Exchange Act of 1934, as amended, together with any and all amendments thereto. This power of attorney shall remain in effect until April 30, 2006, unless earlier terminated by the undersigned in writing. IN WITNESS WHEREOF, the undersigned has executed this power of attorney this 19th day of August, 2002. /s/ James C. Pigott James Calvin Pigott