SEC FORM
4
SEC Form 4
FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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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OMB APPROVAL |
OMB Number: |
3235-0287 |
Estimated average burden |
hours per response: |
0.5 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b). |
1. Name and Address of Reporting Person*
C/O FRIEDMAN FLEISCHER & LOWE |
ONE MARITIME PLAZA, 10TH FLOOR |
(Street)
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2. Issuer Name and Ticker or Trading Symbol
TEMPUR PEDIC INTERNATIONAL INC
[ TPX ]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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3. Date of Earliest Transaction
(Month/Day/Year) 04/25/2005
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4. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
X |
Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
1. Title of Security (Instr.
3)
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2. Transaction Date
(Month/Day/Year) |
2A. Deemed Execution Date, if any
(Month/Day/Year) |
3. Transaction Code (Instr.
8)
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4. Securities Acquired (A) or Disposed Of (D) (Instr.
3, 4 and 5)
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5.
Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr.
3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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7. Nature of Indirect Beneficial Ownership (Instr.
4)
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Code |
V |
Amount |
(A) or (D) |
Price |
Common Stock |
04/25/2005 |
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J
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6,875,620 |
D |
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5,724,840 |
D
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Common Stock |
04/25/2005 |
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J
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124,380 |
D |
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103,563 |
D
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Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
3)
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2. Conversion or Exercise Price of Derivative Security
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3. Transaction Date
(Month/Day/Year) |
3A. Deemed Execution Date, if any
(Month/Day/Year) |
4. Transaction Code (Instr.
8)
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5.
Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr.
3, 4 and 5)
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6. Date Exercisable and Expiration Date
(Month/Day/Year) |
7. Title and Amount of Securities Underlying Derivative Security (Instr.
3 and 4)
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8. Price of Derivative Security (Instr.
5)
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9.
Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr.
4)
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10. Ownership Form: Direct (D) or Indirect (I) (Instr.
4)
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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 |
1. Name and Address of Reporting Person*
C/O FRIEDMAN FLEISCHER & LOWE |
ONE MARITIME PLAZA, 10TH FLOOR |
(Street)
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1. Name and Address of Reporting Person*
C/O FRIEDMAN FLEISCHER & LOWE |
ONE MARITIME PLAZA, 10TH FLOOR |
(Street)
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Explanation of Responses: |
Remarks: |
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/s/ Christopher A. Masto (see general remarks (1)) |
04/27/2005 |
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** Signature of Reporting Person |
Date |
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). |
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
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. |
rrd65387_73644.html
Exhibit 99.1
JOINT FILER INFORMATION
This statement on Form 4 is filed by Friedman Fleischer & Lowe Capital
Partners, LP and FFL Executive Partners, LP.
Name: FFL Executive Partners, LP
Address: c/o Friedman Fleischer & Lowe
One Maritime Plaza, 10th Floor
San Francisco, CA 94111
Designated Filer: Friedman Fleischer & Lowe Capital Partners, LP
Issuer & Ticker Symbol: Tempur-Pedic International Inc. [TPX]
Date of Earliest Transaction Required to be Reported: April 25, 2005
FFL EXECUTIVE PARTNERS, LP
By: /s/ Christopher A. Masto
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Name: Christopher A. Masto
Title: Managing Member
Friedman Fleischer & Lowe GP, LLC
rrd65387_73645.html
Exhibit 99.2
Notes to Footnote 4:
The shares of Common Stock ("Common Stock") described in this Form 4 are held
by Friedman Fleischer & Lowe Capital Partners, LP and FFL Executive Partners,
LP (collectively, the "Friedman Fleischer & Lowe Funds") in the amounts set
forth below. An allocation of shares is listed below for each transaction
described herein. The Friedman Fleischer & Lowe Funds are each controlled by
Friedman Fleischer & Lowe GP, LLC, their general partner. Accordingly,
Friedman Fleischer & Lowe Capital Partners, LP and FFL Executive Partners, LP
may be deemed to beneficially own each other's shares of Common Stock. The
reporting persons disclaim beneficial ownership of any shares in which they
do not have a pecuniary interest.
Shares of Common Shares of Common Stock
Stock Distributed, Directly Owned Following
Holder 4/25/05 Distribution
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Friedman Fleischer & Lowe 6,875,620 5,724,840
Capital Partners, LP
FFL Executive Partners, LP 124,380 103,563