SEC FORM 4 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*
GEORGE BURTON O

(Last) (First) (Middle)
PO BOX 807-663 HWY 60

(Street)
MONETT MO 65708

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
HENRY JACK & ASSOCIATES INC [ JKHY ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/29/2004
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 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 150,136 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
Non-Qualified Stock Option (right to buy) $18.64 10/29/2004 A 10,000(1) 04/29/2005 10/29/2014 Common Stock 10,000 (1) 10,000 D
Non-Qualified Stock Option (right to buy) $6.4063 06/30/2000 11/04/2007 Common Stock 20,000 20,000 D
Non-Qualified Stock Option (right to buy) $6.75 06/30/2000 11/01/2006 Common Stock 30,000 30,000 D
Non-Qualified Stock Option (right to buy) $9.1563 05/03/2000 11/03/2009 Common Stock 30,000 30,000 D
Non-Qualified Stock Option (right to buy) $10.869 05/01/2003 11/01/2012 Common Stock 10,000 10,000 D
Non-Qualified Stock Option (right to buy) $11.9531 06/30/2000 11/03/2008 Common Stock 30,000 30,000 D
Non-Qualified Stock Option (right to buy) $19.83 04/30/2004 10/31/2013 Common Stock 10,000 10,000 D
Non-Qualified Stock Option (right to buy) $25.65 05/05/2002 11/05/2011 Common Stock 30,000 30,000 D
Non-Qualified Stock Option (right to buy) $28.25 05/03/2001 11/03/2010 Common Stock 30,000 30,000 D
Explanation of Responses:
1. Jack Henry & Associats, Inc. 1995 Non-Qualified Stock Option Plan as amended October 29, 2002. The options become exercisable six months from the date of grant.
BURTON O. GEORGE 11/02/2004
** 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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