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RELIV INTERNATIONAL INC·4

Jun 17, 10:45 AM ET

MORTGOMERY SANDRA S 4

4 · RELIV INTERNATIONAL INC · Filed Jun 17, 2004

Insider Transaction Report

Form 4
Period: 2004-05-31
RELIV INTERNATIONAL INCRELV
MORTGOMERY SANDRA S
Director10% Owner
Transactions
  • Exercise/Conversion

    Non-Qualified Stock Option (Right to Buy)

    2004-06-15−100,000→ 213,213 total(indirect: By Spouse)
    Exercise: $1.37From: 1999-12-14Exp: 2004-12-14→ Common Stock (100,000 underlying)
  • Tax Payment

    Common Stock

    2004-06-15$10.07/sh−13,649$137,445→ 1,747,984 total(indirect: By Spouse)
  • Exercise/Conversion

    Common Stock

    2004-06-15$1.37/sh+100,000$137,440→ 1,847,984 total(indirect: By Spouse)
  • Other

    Common Stock

    2004-05-31$10.79/sh+557$6,010→ 1,761,633 total(indirect: By Spouse)
Holdings

  • Common Stock

    140,784

  • Common Stock

    (indirect: by Family LP)
    1,154,970

  • Common Stock

    (indirect: by Corporation)
    470,114
Footnotes (1)
  • [F1]Exempt purchases by husband through Company 401(k) Plan, 92,109 shares owned by husband in Plan through 5/31/04.

Documents

1 file
  • 4
    edgar.xmlPrimary

    PRIMARY DOCUMENT