- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION -----------------------------
FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
- -------- -----------------------------
/ / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287
LONGER SUBJECT TO EXPIRES: DECEMBER 31, 2001
SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN
FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5
CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 -----------------------------
INSTRUCTION 1(b).
- ------------------------------------------------------------------------------------------------------------------------------------
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
Director X 10% Owner
Knowledge Capital Investment Group Franklin Covey Co. (NYSE:FC) ---- ----
- --------------------------------------------------------------------------------------------- Officer (give Other
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify
Number of Reporting Month/Year below) below
Person, if an entity ----------------- ------------------
4200 Chase Tower West, 2200 Ross Avenue (Voluntary) June 2001/September 2001
- -------------------------------------------- ---------------------- 7. Individual or Joint/Group Filing
(Street) 5. If Amendment, (Check Applicable box)
Date of Original X Form filed by One Reporting Person
(Month/Year) ---
Dallas Texas 75201 ---Form filed by More than One
Reporting Person
- ------------------------------------------------------------------------------------------------------------------------------------
(City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
- ------------------------------------------------------------------------------------------------------------------------------------
1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature
(Instr. 3) action action or Disposed of (D) Securities ship of In-
Date Code (Instr. 3, 4 and 5) Beneficially Form: direct
(Instr. 8) Owned at Direct Bene-
(Month/ End of (D) or ficial
Day/ ------------------------------------------- Month Indirect Owner-
Year) (A) or (I) ship
Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4)
and 4)
- ------------------------------------------------------------------------------------------------------------------------------------
Common Stock 1,015,002(1) (D)
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------------------
SEC (11/99)
(Page 1 of 2 Pages)
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
- ------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer-
(Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex-
Exercise Date (Instr. 8) quired (A) or Dis- piration Date
Price of (Month/ posed of (D) (Month/Day/
Deriv- Day/ (Instr. 3, 4, and 5) Year)
ative Year)
Security
--------------------
Date Expira-
-------------------------------------- Exer- tion
cisable Date
Code V (A) (D)
- ------------------------------------------------------------------------------------------------------------------------
Series A Convertible Preferred Stock $14.00 6/15/01 J(1) 19,218.75 (1)
- ------------------------------------------------------------------------------------------------------------------------
Series A Convertible Preferred Stock $14.00 9/15/01 J(1) 19,699.22 (1)
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------
7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature
lying Securities of of Deriv- ship of In-
(Instr. 3 and 4) Deriv- ative Form direct
ative Securi- of De- Bene-
Secur- ties rivative ficial
ity Bene- Secu- Own-
(Instr. ficially rities ership
5) Owned beneficially (Instr. 4)
at End owned at end
Amount or of of month
Title Number of Month (Instr. 4)
Shares (Instr. 4)
- ------------------------------------------------------------------------------------------
Common Stock 137,277 (1) 787,968.81(1) (D)
- ------------------------------------------------------------------------------------------
Common Stock 140,709 (1) 807,668.03(1) (D)
- ------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------
Explanation of Responses:
(1) Shares of Series A Preferred Stock issued to the Reporting Person as a payment-in-kind
dividend. Each share of Series A Preferred Stock is convertible into 7.143 shares of Common
Stock at the option of the holder at any time. The amount of securities beneficially
owned as of November 15, 2001 include 807,668.03 shares of Series A Preferred Stock
(which are convertible into 5,769,057 shares of Common Stock) and 1,015,002 shares
of Common Stock. Donald J. McNamara, who is a principal of the private investment firm
that sponsors the Reporting Person, and Brian A. Krisak, who was a principal of such
firm until September 30, 2001, are members of the Board of Directors of the Company
and may be deemed to beneficially own the securities of the Company held by the
Reporting Person. Mr. McNamara and Mr. Krisak expressly disclaim any beneficial
ownership of such securities.
Reminder: Report on separate lines 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).
/s/ William T. Cavanaugh, Jr.,
as Authorized Person 11/15/01
----------------------------------- -----------
**Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date
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 provided is insufficient, SEE Instruction 6 for procedure.
SEC (11/99)
(Page 2 of 2 Pages)
