SEC FORM 4/A SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
 
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
BLODNICK MICHAEL J

(Last) (First) (Middle)
49 COMMONS LOOP

(Street)
KALISPELL MT 59901

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
GLACIER BANCORP INC [ GBCI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
President/CEO
3. Date of Earliest Transaction (Month/Day/Year)
06/27/2002
4. If Amendment, Date of Original Filed (Month/Day/Year)
07/08/2002
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 06/27/2002 G 809 D $0 48,754 I see footnote(1)
Common Stock 06/28/2002 G 400 D $0 74,295(2) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option $18.31 01/28/2000 01/28/2003 Common Stock 8,451 8,451 D
Option $18.79 01/27/2001 01/27/2004 Common Stock 7,262 15,713 D
Option $13.63 01/26/2002 01/26/2005 Common Stock 2,915 18,628 D
Option $13.56 01/31/2003 01/31/2006 Common Stock 2,825 21,453 D
Option $17.5 11/20/2003 11/20/2006 Common Stock 5,000 26,453 D
Option $21.89 01/30/2004 01/30/2007 Common Stock 2,650 29,103 D
Explanation of Responses:
1. Mr. Blodnick holds 1,601 shares as custodian for his children; 819 shares in a family partnership; 35,937 shares owned by Mr. Blodnick's wife and 10,397 shares in an IRA account for the benefit of Mr. Blodnick's wife.
2. Mr. Blodnick held 64,185 shares directly and 10,110 shares in the Company profit sharing plan. Mr. Blodnick owned 64,585 shares directly prior to gifting 400 shares on 6-28-2002. Following this gift the total number of shares did not reflect the 400 share reduction.
Remarks:
/s/ Michael J. Blodnick 02/03/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line 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).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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