o | Rule 13d-1(b) |
o | Rule 13d-1(c) |
x | Rule 13d-1(d) |
|
1. |
NAME OF REPORTING PERSON | ||
I.R.S. IDENTIFICATION NO. OF ABOVE PERSON (ENTITIES ONLY) | |||
Ray C. Anderson | |||
2. |
CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP | ||
(a) |
o | ||
(b) |
x | ||
3. |
SEC USE ONLY | ||
4. |
CITIZENSHIP OR PLACE OF ORGANIZATION | ||
United States of America | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY EACH REPORTING PERSON WITH | |||
5. |
SOLE VOTING POWER | ||
3,536,728 | |||
6. |
SHARED VOTING POWER | ||
None | |||
7. |
SOLE DISPOSITIVE POWER | ||
3,536,728 | |||
8. |
SHARED DISPOSITIVE POWER | ||
None | |||
9. |
AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON | ||
3,551,728 | |||
|
|||
10. |
CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* | ||
o | |||
11. |
PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9 | ||
7.3% |
|||
12. |
TYPE OF REPORTING PERSON* | ||
IN |
2 | ||
|
Item 1 (a) |
NAME OF ISSUER: |
Interface, Inc. | |
Item 1 (b) |
ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: |
2859 Paces Ferry Road, Suite 2000 | |
Atlanta, Georgia 30339 | |
Item 2 (a) |
NAME OF PERSON FILING: |
Ray C. Anderson | |
Item 2 (b) |
ADDRESS OF PRINCIPAL BUSINESS OFFICE: |
2859 Paces Ferry Road, Suite 2000 | |
Atlanta, Georgia 30339 | |
Item 2 (c) |
CITIZENSHIP: |
United States of America | |
Item 2 (d) |
TITLE OF CLASS OF SECURITIES: |
Class A Common Stock ($0.10 Par Value) | |
Item 2 (e) |
CUSIP NUMBER: |
458665106 | |
Item 3 |
IF THIS STATEMENT IS FILED PURSUANT TO RULE 13d-1(b) OR 13d-2(b) OR (c), CHECK WHETHER THE PERSON FILING IS A: |
Not Applicable | |
Item 4 (a) |
AMOUNT BENEFICIALLY OWNED:
As of December 31, 2004, I was the beneficial owner of 3,551,728 shares of Class A Common Stock for the purpose of Section 13(g) of the Securities Exchange Act of 1934 by virtue of Rule 13d-3. This ownership consisted of (i) 3,417,786 shares of Class B Common Stock (which are convertible on a one-for-one basis into shares of Class A Common Stock) owned directly by me; (ii) 15,000 shares of Class A Common Stock held of record by my wife (as to which I disclaim beneficial ownership); (iii) 93,000 shares of Class A or B Common Stock issuable upon the exercise of stock options which were exercisable on December 31, 2004 or within 60 days thereafter; and (iv) 25,942 shares of Class B Common Stock held by me through the Companys Savings and Investment Plan. |
3 | ||
|
Item 4 (b) |
PERCENT OF CLASS:
If all of the Class B Common Stock I beneficially owned as of December 31, 2004 and all of the shares issuable upon the exercise of stock options that I beneficially owned of as December 31, 2004 (which stock options were exercisable on December 31, 2004 or within 60 days thereafter) were converted into Class A Common Stock, then as of December 31, 2004, I beneficially owned 7.3% of the outstanding Class A Common Stock, computed in accordance with Rule 13d-3. | ||
Item 4 (c) |
NUMBER OF SHARES AS TO WHICH REPORTING PERSON HAS: | ||
(i) |
Sole power to vote or to direct the vote: 3,536,728 | ||
(ii) |
Shared power to vote or to direct the vote: None | ||
(iii) |
Sole power to dispose or to direct the disposition of: 3,536,728 | ||
(iv) |
Shared power to dispose or to direct the disposition of: None | ||
Item 5 |
OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS: | ||
Not Applicable | |||
Item 6 |
OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON: | ||
Not Applicable | |||
Item 7 |
IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY: | ||
Not Applicable | |||
Item 8 |
IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP: | ||
Not Applicable | |||
Item 9 |
NOTICE OF DISSOLUTION OF GROUP: | ||
Not Applicable | |||
4 | ||
|
Item 10 |
CERTIFICATIONS: | |
Not Applicable |
/s/ Ray C. Anderson | |
Ray C. Anderson |
5 | ||