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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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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
TEMPUR PEDIC INTERNATIONAL INC [ TPX ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 02/21/2007 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 02/21/2007 | J(3) | 5,275,000 | D | (5) | 4,479,187 | I | See Footnotes 1 & 2(1)(2) | ||
Common Stock | 02/21/2007 | J(4) | 1,257,468 | A | (5) | 1,257,468 | I | See Footnote 4(4) | ||
Common Stock | 02/21/2007 | J(4) | 1,257,468 | D | (5) | 0 | I | See Footnote 4(4) | ||
Common Stock | 02/21/2007 | J(6) | 12,446 | A | (5) | 38,690 | D |
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) | 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 Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Explanation of Responses: |
1. The reporting person may be deemed to have an indirect pecuniary interest as the General Partner of TA Associates AP IV L.P., and TA Associates SPF L.P. and as the Manager of TA Associates IX LLC, TA Associates VIII LLC, TA Associates SDF LLC, and TA Investors LLC. The reporting person disclaims beneficial ownership of such shares because the reporting person's indirect pecuniary interest is subject to indeterminable future events. |
2. The reporting person is the indirect beneficial owner of the following shares of Common Stock: (i) 2,655,725 shares owned by TA IX L.P.; (ii) 669,274 shares owned by TA/Advent VIII L.P.; (iii) 665,419 shares owned by TA/Atlantic and Pacific IV L.P.; (iv) 119,951 shares owned by TA Strategic Partners Fund A L.P.;(v) 22,048 shares owned by TA Strategic Partners Fund B L.P.; (vi) 259,610 shares owned by TA Subordinated Debt Fund L.P.; and (vii) 87,160 shares owned by TA Investors LLC. |
3. TA IX L.P., TA/Advent VIII L.P., TA/Atlantic and Pacific IV L.P., TA Subordinated Debt Fund L.P. and TA Investors LLC, members of a group that owns more than 10% of Tempur-Pedic International, Inc. in the aggregate, distributed 5,275,000 shares, in the aggregate, for no consideration to the partners of TA IX L.P., TA/Advent VIII L.P., TA/Atlantic and Pacific IV L.P., TA Subordinated Debt Fund L.P., and TA Investors LLC, respectively. |
4. As the General Partner and a Limited Partner of TA IX L.P., TA Associates IX LLC received 848,140 shares in the distribution of which they distributed 848,140 shares for no consideration to the partners of TA Associates IX LLC. As the General Partner and a Limited Partner of TA/Advent VIII L.P., TA Associates VIII LLC received 170,218 shares in the distribution of which they distributed 170,218 shares for no consideration to the partners of TA Associates VIII LLC. As the General Partner and a Limited Partner of TA/Atlantic and Pacific IV L.P., TA Associates AP IV L.P. received 168,910 shares in the distribution of which they distributed 168,910 shares for no consideration to the partners of TA Associates AP IV L.P. As the General Partner and a Limited Partner of TA Subordinated Debt Fund L.P., TA Associates SDF LLC received 70,200 shares in the distribution of which they distributed 70,200 shares for no consideration to the partners of TA Associates SDF LLC. |
5. Not Applicable |
6. TA Associates, Inc. received 8,481 shares from TA Associates IX LLC, 1,574 shares from TA Associates VIII LLC, 1,689 shares from TA Associates AP IV L.P. and 702 shares from TA Associates SDF LLC. |
Remarks: |
Member of a filing group which owns more than 10% in the aggregate. |
TA Associates, Inc. | 02/21/2007 | |
By: Thomas P. Alber, Chief Financial Officer | 02/21/2007 | |
** 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. |