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dkm90.txt
FORM 3 FOR DANIEL G. LIBARLE
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OMB APPROVAL
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OMB Number 3235-0104
Expires: January 31, 2005
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Libarle Daniel G.
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(Last) (First) (Middle)
128 Liberty Street
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(Street)
Petaluma CA 94952
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
June 17, 2002*
*anticipated effective date of
Hennessy Advisors, Inc. Form 8-A
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
Hennessy Advisors, Inc.
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
_______________________
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6. If Amendment, Date of Original (Month/Day/Year)
________________________________________________________________________________
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 Beneficially Owned
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3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4)
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Common Stock, no par value 5,000 D
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* If the Form is filed by more than one Reporting Person, see Instruction
5(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
(Form 3-07/98)
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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Stock Option
(right to acquire) 2/28/02 2/28/12 Common Stock 10,000 $10.00 D
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Explanation of Responses:
/s/ Linda Y. Kelso June 13, 2002
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Linda Y. Kelso, as attorney-in-fact for
Daniel G. Libarle
** 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.
EXHIBIT A
POWER OF ATTORNEY
KNOW ALL MEN BY THESE PRESENTS, that the undersigned, whose
signature appears below, constitutes and appoints Neil J. Hennessy, Teresa M.
Nilsen and Linda Y. Kelso, and each or either of them, as such person's true and
lawful attorney-in-fact and agent, with full power of substitution and
resubstitution, for such person in his/her name, place and stead, in any and all
capacities, to sign the undersigned's Form 3 and any and all Forms 4 or 5 (and
any amendments to any of the foregoing) relating to the securities of Hennessy
Advisors, Inc. required to be filed with the Securities and Exchange Commission
by the undersigned for the period beginning from the date hereof through
December 31, 2003, as such forms may be promulgated from time to time under
Section 16 of the Securities Exchange Act of 1934, as amended, and to file the
same with the Securities and Exchange Commission, granting unto said
attorney-in-fact and agent full power and authority to do and perform each and
every act and thing requisite and necessary to be done in and about the
premises, as fully to all intents and purposes as he/she might or could do in
person, hereby ratifying and confirming all that said attorneys-in-fact and
agents or his or her substitute may lawfully do or cause to be done by virtue
hereof.
IN WITNESS WHEREOF, the undersigned has executed this Power of
Attorney as of the 24th day of January, 2002.
/s/ Daniel G. Libarle
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Daniel G. Libarle