UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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FORM 4
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 Holding Company Act of 1935 or
Section 30(h) of the Investment Company Act of 1940
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Rollins, Glen W.
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(Last) (First) (Middle)
2170 Piedmont Road NE
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(Street)
Atlanta, GA 30324
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Rollins, Inc. (ROL)
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3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary)
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4. Statement for Month/Day/Year
12/27/02
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
Executive VP Orkin Exterminating Company
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7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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5.
Amount of 6.
2A. 4. Securities Owner-
Deemed Securities Acquired (A) or Beneficially ship
2. Execution 3. Disposed of (D) Owned Form: 7.
Transaction Date, Transaction (Instr. 3, 4 and 5) Following Direct Nature of
Date if any Code ---------------------------- Reported (D) or Indirect
1. (Month/ (Month/ (Instr. 8) (A) Transaction(s) Indirect Beneficial
Title of Security Day/ Day/ ----------- Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) Year) Year) Code V (D) and 4) (Instr. 4) (Instr. 4)
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Rollins, Inc. 12/27/02 G V 754 A 151,241** D
Common Stock $1
Par Value
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Rollins, Inc. 12/27/02 G V 754 A 11,564 I By Spouse
Common Stock $1
Par Value
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Rollins, Inc. 12/27/02 G V 7,784 A 43,933 I Custodian/
Common Stock $1 Guardian for
Par Value minor children
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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).
** This number includes 4,674 shares of 401(k) stock and 136 Purchase Plan
shares first reported in January 2002.
(Over)
SEC 1474 (7/96)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9.
Number 10.
of Owner-
Deriv- ship
2. ative Form
Conver- 5. 7. Secur- of 11.
sion Number of Title and Amount ities Deriv- Nature
or 3A. Derivative 6. of Underlying 8. Bene- ative of
Exer- Deemed 4. Securities Date Securities Price ficially Secur- In-
cise 3. Execu- Trans- Acquired (A) Exercisable and (Instr. 3 and 4) or Owned ity: direct
Price Trans- tion action or Disposed Expiration Date ---------------- Deriv- Following Direct Bene-
1. of action Date, Code of (D) (Month/Day/Year) Amount ative Reported (D) or ficial
Title of Deriv- Date if any (Instr. (Instr. 3, ---------------- or Secur- Trans- Indirect Owner-
Derivative ative (Month/ (Month/ 8) 4 and 5) Date Expira- Number ity action(s) (I) ship
Security Secur- Day/ Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr, 3) ity Year) Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Explanation of Responses:
/s/ Glen W. Rollins
Signed by Glen P. Grove, Jr.
As Power of Attorney December 31, 2002
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**Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
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.
Page 2
CONFIRMING STATEMENT
This Statement confirms that the undersigned, Glen W. Rollins, has authorized
and designated Glenn P. Grove, Jr. to execute and file 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 U.S. Securities and Exchange
Commission as a result of the undersigned's ownership of or transactions in
securities of Rollins, Inc. The authority of Glenn P. Grove, Jr. under this
Statement 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 Rollins, Inc., unless earlier revoked in writing. The
undersigned acknowledges that Glenn P. Grove, Jr. is not assuming any of the
undersigned's responsibilities to comply with Section 16 of the Securities
Exchange Act of 1934.
/s/ Glen W. Rollins
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Glen W. Rollins