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
 
OMB APPROVAL
OMB Number: 3235-0104
Estimated average burden
hours per response: 0.5
1. Name and Address of Reporting Person*
CHUMBLEY BOYD BROOKS

(Last) (First) (Middle)
101 SOUTH MAIN STREET

(Street)
HIGH POINT NC 27260

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
06/15/2004
3. Issuer Name and Ticker or Trading Symbol
CULP INC [ CFI ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
President, CVP division
5. If Amendment, Date of Original Filed (Month/Day/Year)
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 Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 2,576(1) I 401(k) Plan
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Incentive Stock Option (right to buy)(2) 09/20/1995 09/19/2004 Common Stock 2,000 9 D
Incentive Stock Option (right to buy)(2) 07/03/1996 07/02/2005 Common Stock 3,000 7.75 D
Incentive Stock Option (right to buy)(2) 07/19/1997 07/18/2006 Common Stock 2,000 12.13 D
Incentive Stock Option (right to buy)(2) 12/16/1998 12/15/2007 Common Stock 2,000 20.25 D
Incentive Stock Option (right to buy)(2) 06/28/2000 06/27/2009 Common Stock 2,000 9.125 D
Incentive Stock Option (right to buy)(2) 03/29/2002(4) 03/28/2006 Common Stock 3,000 3.03 D
Incentive Stock Option (right to buy)(2) 06/12/2002(4) 06/11/2006 Common Stock 10,000 4.1 D
Incentive Stock Option (right to buy)(3) 06/21/2003(4) 06/20/2007 Common Stock 3,500 13.99 D
Incentive Stock Option (right to buy)(3) 06/17/2004(4) 06/16/2008 Common Stock 3,500 6.61 D
Incentive Stock Option (righ to buy)(3) 06/15/2005(4) 06/14/2009 Common Stock 9,000 7.13 D
Non-Qualified Stock Option (right to buy)(5) 01/01/2006 12/31/2006 Common Stock 7,000 1 D
Explanation of Responses:
1. These shares are held indirectly through units in an investment fund that owns primarily Company shares. The number of shares is an estimated number based on allocations profided by the plan administrator.
2. Employee stock option (right to buy) granted pursuant to the Culp, Inc. 1993 Stock Option Plan in reliance upon the exemption provided by Rule 16b-3(d).
3. Employee stock option (right to buy) granted pursuant to the Culp, Inc. 2002 Stock Option Plan in reliance upon the exemption provided by Rule 16b-3(d).
4. These options vest in four equal annual installments beginning on the date noted.
5. Employee stock option (right to buy) granted pursuant to the Culp, Inc. 1997 Performance-Based Option Plan in reliance upon the exemption provided by Rule 16b-3(d).
Boyd B. Chumbley 06/23/2004
** 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 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.