- Annual Statement of Changes in Beneficial Ownership (5)
15 Dezember 2011 - 12:15AM
Edgar (US Regulatory)
FORM 5
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
[ ]
Form 3 Holdings Reported
[ ]
Form 4 Transactions Reported
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0362
Expires:
January 31, 2014
Estimated average burden
hours per response...
1.0
|
|
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
|
|
1. Name and Address of Reporting Person
*
Shaw Deborah
|
2. Issuer Name
and
Ticker or Trading Symbol
VOLT INFORMATION SCIENCES, INC. [VISI]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
|
(Last)
(First)
(Middle)
2908 MAPLE AVENUE
|
3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
10/30/2011
|
(Street)
MANHATTAN BEACH, CA 90266
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
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. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. 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)
|
Amount
|
(A) or (D)
|
Price
|
Common Stock, $0.10 par value
|
|
|
|
|
|
|
320416
(1)
|
D
|
|
Common Stock, $0.10 par value
|
12/1/2010
|
|
G
|
230142
|
D
|
$
0
|
1332369
(1)
|
I
|
By GRATs
(2)
|
Common Stock, $0.10 par value
|
6/9/2011
|
|
G
|
29688
|
D
|
$
0
|
1262857
(1)
|
I
|
By GRATs
(2)
|
Common Stock, $0.10 par value
|
|
|
|
|
|
|
71220
|
I
|
As custodian
(3)
(4)
|
Common Stock, $0.10 par value
|
|
|
|
|
|
|
23019
|
I
|
By Spouse
(4)
|
Common Stock, $0.10 par value
|
|
|
|
|
|
|
34584
|
I
|
By Spouse as custodian
(4)
(6)
|
Common Stock, $0.10 par value
|
12/1/2010
|
|
G
|
230142
|
A
|
$
0
|
230142
|
I
|
By Spouse as Co-Trustee
(3)
(5)
|
Common Stock, $0.10 par value
|
6/9/2011
|
|
G
|
29688
|
A
|
$
0
|
259830
|
I
|
By Spouse as Co-Trustee
(3)
(5)
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Trans. Date
|
3A. Deemed Execution Date, if any
|
4. Trans. 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
(MM/DD/YYYY)
|
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 at End of Issuer's Fiscal Year
(Instr. 4)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
|
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
|
(A)
|
(D)
|
Date Exercisable
|
Expiration Date
|
Title
|
Amount or Number of Shares
|
Stock Option (Right to Buy)
|
$
6.39
|
|
|
|
|
|
(7)
|
4/6/2019
|
Common Stock, $0.10 par value
|
3000
|
|
3000
|
D
|
|
Explanation of Responses:
|
(
1)
|
Column 5 of Table 1 gives effect to all transactions, including contributions to, and all annuity distributions from, Grantor Retained Annuity Trusts ("GRATs") created by the reporting person through the date set forth in Column 2 (except that the final amount shown as owned directly or through GRATs is at the end of the fiscal year covered by this Report). Certain of the transactions may not be reportable and, therefore, amounts shown in Column 5 may not foot to the amount previously reported as owned.
|
(
2)
|
Held by Grantor Retained Annuity Trusts ("GRATs") created by, and the sole trustee and sole annuitant of which is, the reporting person are exempt from reporting pursuant to Rule 16a-13.
|
(
3)
|
Held by the reporting person as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
|
(
4)
|
The filing of this statement shall not be construed as an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of these securities.
|
(
5)
|
Held by the reporting person's spouse and his sister as co-trustees of trusts for the benefit of the children of the reporting person.
|
(
6)
|
Held by the reporting person's spouse as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
|
(
7)
|
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.
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
Shaw Deborah
2908 MAPLE AVENUE
MANHATTAN BEACH, CA 90266
|
X
|
|
|
|
Signatures
|
/s/ Deborah Shaw
|
|
12/14/2011
|
**
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).
|
Note:
|
File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
|
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.
|
Volt Information Sciences (AMEX:VISI)
Historical Stock Chart
Von Jun 2024 bis Jul 2024
Volt Information Sciences (AMEX:VISI)
Historical Stock Chart
Von Jul 2023 bis Jul 2024
Echtzeit-Nachrichten über Volt Information Sciences Inc (Amerikanische Börse): 0 Nachrichtenartikel
Weitere Volt Information Sciences (PL) News-Artikel