-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, GGEMwghNwopN4LLw3a6cxC+gb8quVShlLzEKkdU8F6bW5aeo36MbvP4E+awWcVCF P4uLMV1ShsLlCXApUpHeew== 0001097715-01-500005.txt : 20010628 0001097715-01-500005.hdr.sgml : 20010628 ACCESSION NUMBER: 0001097715-01-500005 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010627 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SMITH MIDLAND CORP CENTRAL INDEX KEY: 0000924719 STANDARD INDUSTRIAL CLASSIFICATION: CONCRETE PRODUCTS, EXCEPT BLOCK & BRICK [3272] IRS NUMBER: 541727060 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-60031 FILM NUMBER: 1668343 BUSINESS ADDRESS: STREET 1: ROUTE 28 STREET 2: P O BOX 300 CITY: MIDLAND STATE: VA ZIP: 22728 BUSINESS PHONE: 5404393266 MAIL ADDRESS: STREET 1: P.O. BOX 300 STREET 2: P.O. BOX 300 CITY: MIDLAND STATE: VA ZIP: 22728 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: SOURLIS VIRGINIA K ESQ CENTRAL INDEX KEY: 0001097715 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: PO BOX 237 CITY: RED BANK STATE: NJ ZIP: 07701 MAIL ADDRESS: STREET 1: PO BOX 237 CITY: RED BANK STATE: NJ ZIP: 07701 SC 13G 1 sch13gkassner.txt ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0145 Expires: October 31, 2002 Estimated average burden hours per response .......14.9 ------------------------------ SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b)(c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(b) (Amendment No. )(0) SMITH MIDLAND CORPORATION - -------------------------------------------------------------------------------- (Name of Issuer) COMMON STOCK - -------------------------------------------------------------------------------- (Title of Class of Securities) 832156103 - -------------------------------------------------------------------------------- (CUSIP Number) - -------------------------------------------------------------------------------- (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [_] Rule 13d-1(b) [x] Rule 13d-1(c) [_] Rule 13d-1(d) - ---------- (1) The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). (SC13G-07/98) CUSIP No. 832156103 13G Page 2 of 5 Pages ________________________________________________________________________________ 1. NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) FRED E. KASSNER (ESTATE OF) ________________________________________________________________________________ 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] (b) [_] ________________________________________________________________________________ 3. SEC USE ONLY ________________________________________________________________________________ 4. CITIZENSHIP OR PLACE OF ORGANIZATION UNITED STATES ________________________________________________________________________________ NUMBER OF 5. SOLE VOTING POWER SHARES 589,172 _________________________________________________________________ BENEFICIALLY 6. SHARED VOTING POWER OWNED BY 0 _________________________________________________________________ EACH 7. SOLE DISPOSITIVE POWER REPORTING 589,172 _________________________________________________________________ PERSON 8. SHARED DISPOSITIVE POWER WITH 0 ________________________________________________________________________________ 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 589,172 ________________________________________________________________________________ 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] ________________________________________________________________________________ 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 19.3 ________________________________________________________________________________ 12. TYPE OF REPORTING PERSON* IN ________________________________________________________________________________ *SEE INSTRUCTIONS BEFORE FILLING OUT! CUSIP No. 832156103 13G Page 3 of 5 Pages ________________________________________________________________________________ Item 1(a). Name of Issuer: SMITH MIDLAND CORPORATION, a Delaware corporation (the "Company") ________________________________________________________________________________ Item 1(b). Address of Issuer's Principal Executive Offices: ROUTE 28, P.O. BOX 300, MIDLAND, VIRGINIA 22728 ________________________________________________________________________________ Item 2(a). Name of Person Filing: FRED E. KASSNER (ESTATE OF) ________________________________________________________________________________ Item 2(b). Address of Principal Business Office, or if None, Residence: 69 SPRING STREET, RAMSEY, NEW JERSEY 07446 ________________________________________________________________________________ Item 2(c). Citizenship: UNITED STATES ________________________________________________________________________________ Item 2(d). Title of Class of Securities: COMMON STOCK, $0.01 PAR VALUE ________________________________________________________________________________ Item 2(e). CUSIP Number: 832156103 ________________________________________________________________________________ Item 3. If This Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a: (a) [_] Broker or dealer registered under Section 15 of the Exchange Act. (b) [_] Bank as defined in Section 3(a)(6) of the Exchange Act. (c) [_] Insurance company as defined in Section 3(a)(19) of the Exchange Act. (d) [_] Investment company registered under Section 8 of the Investment Company Act. (e) [_] An investment adviser in accordance with Rule 13d-1(b)(1)(ii)(E); (f) [_] An employee benefit plan or endowment fund in accordance with Rule 13d-1(b)(1)(ii)(F); (g) [_] A parent holding company or control person in accordance with Rule 13d-1(b)(1)(ii)(G); (h) [_] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act; (i) [_] A church plan that is excluded from the definition of an investment company under Section 3(c)(14) of the Investment Company Act; (j) [_] Group, in accordance with Rule 13d-1(b)(1)(ii)(J). If this statement is filed pursuant to Rule 13d-1(c), check this box. [x] CUSIP No. 832156103 13G Page 4 of 5 Pages Item 4. Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: See Row 9 of cover page (b) Percent of class: See Row 11 of cover page (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote See Row 5 of cover page, (ii) Shared power to vote or to direct the vote See Row 6 of cover page, (iii) Sole power to dispose or to direct the disposition of See Row 7 of cover page, (iv) Shared power to dispose or to direct the disposition of See Row 8 of cover page ________________________________________________________________________________ Item 5. Ownership of Five Percent or Less of a Class. NOT APPLICABLE ________________________________________________________________________________ Item 6. Ownership of More Than Five Percent on Behalf of Another Person. NOT APPLICABLE ________________________________________________________________________________ Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. NOT APPLICABLE ________________________________________________________________________________ Item 8. Identification and Classification of Members of the Group. NOT APPLICABLE ________________________________________________________________________________ Item 9. Notice of Dissolution of Group. NOT APPLICABLE ________________________________________________________________________________ Item 10. Certifications. (a) The following certification shall be included if the statement is filed pursuant to Rule 13d-1(b): "By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having such purpose or effect." NOT APPLICABLE (b) The following certification shall be included if the statement is filed pursuant to Rule 13d-1(c): "By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having such purpose or effect." CUSIP No. 832156103 13G Page 5 of 5 Pages SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. June 25, 2001 (Date) /s/MICHELLE KASSNER, CO-EXECUTOR, ESTATE OF FRED E. KASSNER (Signature) MICHELLE KASSNER, CO-EXECUTOR, ESTATE OF FRED E. KASSNER (Name/Title) Note. Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7(b) for other parties for whom copies are to be sent. Attention. Intentional misstatements or omissions of fact constitute federal criminal violations (see 18 U.S.C. 1001). -----END PRIVACY-ENHANCED MESSAGE-----