SEC FORM 5 SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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).
Form 3 Holdings Reported.
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
BLACK TODD R

(Last) (First) (Middle)
6 LIBERTY LANE WEST

(Street)
HAMPTON NH 03842

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
UNITIL CORP [ UTL ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
Officer (give title below) X Other (specify below)
Vice President
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2003
4. 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 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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock, no par value 06/09/2003 A(1) 4 A $24.49 0 D
Common Stock, no par value 11/14/2003 J(2) 0.054 A $25.34 0 D
Common Stock, no par value 11/14/2003 J(2)(3) 6.806 A $25.34 1,010.86 D
Common Stock, no par value 01/01/2003 J(4) 7.715 D $26.34 371.62 I Held in trust(5)
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Common Stock Options $0 08/08/1988 08/08/1988 None 0 6,000(6) D
Explanation of Responses:
1. Shares granted in connection with a length of service award for five years of service to the Company.
2. Acquisition pursuant to reinvestment of dividends.
3. Acquisition pursuant to reinvestment of dividends on shares of restricted stock granted pursuant to the Unitil Corporation Restricted Stock Plan.
4. Shares were purchased between January 1 - December 31, 2003 at a range of prices between $23.05 and $26.34 under the terms and conditions of the Unitil Corporation Tax Deferred Savings and Investment Plan.
5. Shares are held in trust under the terms of the Unitil Corporation Tax Deferred Savings and Investment Plan.
6. Options were granted under the terms and conditions of the Company's 1998 Stock Option Plan and previously reported on Form 3.
/s/ Todd R. Black 02/04/2004
** 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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