SEC FORM
3
SEC Form 3
FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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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OMB APPROVAL |
OMB Number: |
3235-0104 |
Estimated average burden |
hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
1000 ABERNATHY ROAD |
SUITE 1200 |
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 08/23/2007
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3. Issuer Name and Ticker or Trading Symbol
BEAZER HOMES USA INC
[ BZH ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
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10% Owner |
X |
Officer (give title below) |
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Other (specify below) |
EVP Special Counsel
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
X |
Form filed by One Reporting Person |
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Form filed by More than One Reporting Person |
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Table I - Non-Derivative Securities Beneficially Owned |
1. Title of Security (Instr.
4)
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2.
Amount of Securities Beneficially Owned (Instr.
4)
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3. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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4. Nature of Indirect Beneficial Ownership (Instr.
5)
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Common Stock |
0 |
D |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr.
4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form: Direct (D) or Indirect (I) (Instr.
5)
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6. Nature of Indirect Beneficial Ownership (Instr.
5)
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
Explanation of Responses: |
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/s/ Michael R. Douglas |
08/29/2007 |
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** 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
5
(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). |
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure. |
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |
CONFIRMING STATEMENT
and
LIMITED POWER OF ATTORNEY
This statement confirms that the undersigned,
MICHAEL R. DOUGLAS, has authorized, appointed and
designated the following individuals as the
undersigned's Attorney in Fact for the sole and
limited purpose of executing and filing on the
undersigned's behalf all Forms 3, 4 and 5 (including
any amendments thereto) that the undersigned may be
required to file with the Securities and Exchange
Commission as a result of the undersigned's ownership
of or transactions in securities of BEAZER HOMES USA,
INC:
Ian J. McCarthy
Allan P. Merrill
Peggy J. Caldwell
Each of these individuals is authorized to act alone,
without the consent of any of the others, and the
authority of under this Statement and Limited Power of
Attorney shall continue until the undersigned is no
longer required to file Forms 3, 4, and 5 with regard
to the undersigned's ownership of or transactions in
securities of BEAZER HOMES USA, INC., unless earlier
revoked in writing. The undersigned acknowledges that
the said Attorney in Fact is not assuming any of the
undersigned's responsibilities to comply with Section
16 of the Securities Exchange Act of 1934.
Date: 8/29/07 Signature: /s/ Michael R. Douglas