5 1NEW YORK 0000903198 Director MOHAWK INDUSTRIES, INC. 40851968 52-1604305 12/31/02 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported 1. Name and Address of Reporting Person(s) KOLB, DAVID L. P.O. BOX 12069 CALHOUN, GA 30703 2. Issuer Name and Ticker or Trading Symbol MOHAWK INDUSTRIES, INC. (MHK) 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Statement for Month/Year 12/02 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [ ] 10% Owner [ ] Officer (give title below) [X] Other (specify below) Chairman 7. Individual or Joint/Group Filing (Check Applicable Line) [X] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person SIGNATURE OF REPORTING PERSON /S/ KOLB, DAVID L. DATE 02/11/03
Table I Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Security 2)Trans- 3.Trans- 4.Securities Acquired(A) 5)Amount of 6) 7)Nature of action action or Disposed of (D) Securities Indirect Date Code A Beneficially D Beneficial (Month/ or Owned at or Ownership Day/Year) Code Amount D Price End of Year I - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 05/15/02 G 150 D 476,219 D Direct Common Stock 4,820 I Minor Children Common Stock 703 I by Managed Account Table II (PART 1) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 2)Conversion 3)Trans- 4)Trans- 5)Number of Derivative 6)Date Exercisable and Security or Exercise action action Securities Acquired (A) Expiration Date Price of Date Code or Disposed of (D) Derivative Security Code A D Exercisable Expiration - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option $23.3281 01/01/11 (right to buy) Non-Qualified Stock Option $38.7275 01/01/12 (right to buy) Put Option (right to sell) $55.8875 05/14/04 05/14/04 Put Option (right to sell) $59.2700 05/20/04 05/20/04 Table II (PART 2) Derivative Securitites Acquired, Disposed of, or Beneficially Owned (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1)Title of Derivative 3)Trans- 7)Title and Amount 8)Price 9)Number of 10) 11)Nature of Security action of Underlying of Deri- Derivative Indirect Date Securities vative Securities D Beneficial Amount or Security Beneficially or Ownership Number of Owned at I - Title Shares End of Year - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified Stock Option Common Stock 2,250 2,250 D Direct (right to buy) Non-Qualified Stock Option Common Stock 2,250 2,250 D Direct (right to buy) Put Option (right to sell) Common Stock 50,000 50,000 D Direct Put Option (right to sell) Common Stock 50,000 50,000 D Direct Explanation of Responses: