Amended Statement of Changes in Beneficial Ownership (4/a)
29 Dicembre 2014 - 10:55PM
Edgar (US Regulatory)
FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
SHAW JEROME
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2. Issuer Name
and
Ticker or Trading Symbol
VOLT INFORMATION SCIENCES, INC.
[
VISI
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Exec VP
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(Last)
(First)
(Middle)
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3. Date of Earliest Transaction
(MM/DD/YYYY)
7/8/2010
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(Street)
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
12/29/2014
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6. 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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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock, $0.01 par value
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7/8/2010
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P
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175
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A
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$8.7363
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10000
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I
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By Spouse
(1)
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Common Stock, $0.01 par value
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12/26/2013
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J
(2)
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252191
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A
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$0
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1052583
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I
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Co-trustees
(1)
(3)
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Common Stock, $0.01 par value
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2578
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I
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By ESOP
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Common Stock, $0.01 par value
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24721
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I
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By 401k Plan
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Common Stock, $0.01 par value
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3229
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D
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Common Stock, $0.01 par value
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1398318
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I
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Revocable (Living) Trust
(4)
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Common Stock, $0.01 par value
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12750
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I
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Family Foundation
(1)
(5)
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Employee Stock Option (Right to Buy)
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$6.39
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(6)
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4/6/2019
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Common Stock, $0.01 par value
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8000
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8000
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D
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Explanation of Responses:
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(
1)
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Filing of this statement shall not be construed as an admission the reporting person is, for purposes of Section 16 of the Securi9ties Exchange Act of 1934 or otherwise, the beneficial owner of these securities.
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(
2)
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Contribution, without consideration, to trust by beneficiary of trust.
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(
3)
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Held by reporting person and his spouse as co-trustees of a trust for the benefit of the daughter of the reporting person.
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(
4)
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Held by the reporting person and his spouse as co-trustees of a revocable (living) trust for the benefit of the reporting person and his spouse.
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(
5)
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Held by a family foundation. The reporting person and his spouse are officers and directors of this foundation.
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(
6)
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The option is exercisable in 20% annual installments, on a cumulative basis, commencing April 7, 2010, one year after the date of grant of the option.
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Remarks:
Amendment filed to correct holdings.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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SHAW JEROME
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X
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X
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Exec VP
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Signatures
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/Jerome Shaw/
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12/29/2014
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number.
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