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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 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 | ||||||||
Senior Secured Convertible Note due 2006 | $ 5.3251 (3) | 05/05/2004 | C | $ 20,000,000 | 11/27/2001 | 11/26/2006 | Common Stock | 3,755,792 (3) | (1) | 0 | I (2) | See Footnote (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
EQUIFAX INC 1550 PEACHTREE STREET, NW ATLANTA, GA 30309 |
(See Remarks Below) | |||
CD HOLDINGS INC 1550 PEACHTREE STREET, NW ATLANTA, GA 30309 |
(See Remarks Below) | |||
EQUIFAX CONSUMER SERVICES INC 1550 PEACHTREE STREET, NW ATLANTA, GA 30309 |
(See Remarks Below) | |||
HEROMAN DONALD T 1550 PEACHTREE STREET, NW ATLANTA, GA 30309 |
(See Remarks Below) |
/s/ Donald T. Heroman, Chief Financial Officer - Equifax Inc. | 05/05/2004 | |
**Signature of Reporting Person | Date | |
/s/ Donald T. Heroman, President - CD Holdings Inc. | 05/05/2004 | |
**Signature of Reporting Person | Date | |
/s/ Donald T. Heroman, Vice President - Equifax Consumer Services, Inc. | 05/05/2004 | |
**Signature of Reporting Person | Date | |
/s/ Donald T. Heroman | 05/05/2004 | |
**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) | The reported transaction represents the conversion of derivative securities of INTX, with no additional consideration paid. |
(2) | The reported securities are (or, in the case of the securities disposed of, were) owned directly by CD Holdings Inc., which is a wholly owned subsidiary of Equifax Consumer Services, Inc., which is a wholly-owned subsidiary of Equifax Inc. Equifax Consumer Services, Inc. and Equifax Inc. are indirect beneficial owners of the reported securities. Mr. Heroman disclaims beneficial ownership of the reported securities. |
(3) | After giving effect to a 554.9338-for-one stock split of INTX's Common Stock, which was effected immediately prior to the closing of INTX's initial public offering. |
Remarks: This report is filed jointly by CD Holdings Inc., Equifax Consumer Services, Inc., Equifax Inc. and Donald T. Heroman, all of whom were or may be deemed to have been 10% owners as of the date of the transactions reported. Mr. Heroman was a director, and CD Holdings Inc. may be deemed to have been a director by virtue of its right to nominate a representative to serve on INTX's Board of Directors. Donald T. Heroman was CD Holdings Inc.'s representative on INTX's Board but is no longer a director of INTX. |