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FORM 5 |
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility |
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Check this box if no longer subject to |
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Form 3 Holdings Reported |
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Form 4 Transactions Reported |
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1. Name and Address of Reporting Person*
Smith Jan E. |
2. Issuer Name and Ticker or Trading Symbol BRO |
6. Relationship of Reporting Person(s) to Issuer |
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X |
Director |
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10% Owner |
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Officer (give |
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Other (specify |
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(Last) (First) (Middle) 1111 Third Ave. W., Ste. 110 |
3. I.R.S. Identification
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4. Statement for Month/Year December/2002 |
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5. If Amendment, Date of
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X |
Form Filed by One Reporting Person |
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(Street) Bradenton FL 34205 |
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Form Filed by More than One Reporting Person |
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(City) (State) (Zip) |
Table I ¾ Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Security
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2. Trans- |
2A. Deemed |
3. Trans- |
4. Securities Acquired (A) or |
5. Amount of |
6. Owner- |
7. Nature of |
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Amount |
(A) or |
Price |
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Common Stock, $.10 par value |
5/23/02 |
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A |
500 |
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N/A |
500 |
D |
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Common Stock, $.10 par value |
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2,000 |
I |
IRA Account |
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Common Stock, $.10 par value |
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1,400 |
I |
Spouse (1) |
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* |
If the form is filed by more than one reporting person, see instruction 4(b)(v). |
Persons who respond to the collection of information contained in |
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(Over) |
(1) The reporting person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the reporting person is the
beneficial owner of such securities for the purpose of Section 16 or for any other purpose.
FORM 5 (continued) |
Table II ¾ Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of Derivative
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2. Conver-
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3. Trans |
3A. Deem
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4. Trans- |
5. Number of Deriva- |
6. Date Exercis- |
7. Title and Amount of Underly- |
8. Price |
9. Number |
10. Owner-
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11. Nature of
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(A) |
(D) |
Date |
Expira- |
Title |
Amount or |
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Explanation of Responses: |
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/S/ JAN E. SMITH |
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1/21/03 |
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** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
**Signature of Reporting Person |
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Date |
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See18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
Jan E. Smith |
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Note: File three copies of this Form, one of which must be manually signed. |
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Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
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Page 2 |
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SEC2270 (9-02) |