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FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL
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/ / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
LONGER SUBJECT TO
SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934,
FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or
CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940
INSTRUCTION 1(b).
(Print or Type Responses)
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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) ---- ----
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify
Number of Reporting Month/Year below) below
Person (Voluntary) ----------------- ------------------
4200 Texas Commerce Tower West, 2200 Ross Avenue December 2001
- -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing
(Street) 5. If Amendment, (Check Applicable Line)
Date of Original X Form filed by One Reporting Person
(Month/Year) ---
Form filed by More than One
Reporting Person
Dallas Texas 75201 ---
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(City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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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)
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
SEC 1474 (8/92)
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FORM 4 (CONTINUED) 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 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
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Date Expira-
-------------------------------------- Exer- tion
cisable Date
Code V (A) (D)
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Series A Convertible Preferred Stock $14.00 12/31/2001 J(1) 20,191.70 (1)
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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 rity: ership
5) Owned Direct (Instr. 4)
at End (D) or
Amount or of Indi-
Title Number of Month rect (I)
Shares (Instr. 4) (Instr. 4)
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Common Stock 144,226 (1) 827,859.67 D
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Explanation of Responses:
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
(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. Donald J. McNamara, who is a principal of the
private investment firm that sponsors the Reporting Person, is a member
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 expressly disclaims any beneficial ownership of
such securities.
Note: File three copies of this Form, one of which must be manually signed. /s/ KYMBERLYN J. IRVIN 5/10/2002
If space is insufficient, SEE Instruction 6 for procedure. ----------------------------------- ----------
Kymberlyn J. Irvin Date
Authorized Signatory
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SEC 1474 (8-92)
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