Statement of Changes in Beneficial Ownership (4)
14 Juni 2016 - 1:15AM
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
*
Dean Michael D.
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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
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President & CEO
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(Last)
(First)
(Middle)
C/O VOLT INFORMATION SCIENCES, INC., 1133 AVENUE OF THE AMERICAS
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3. Date of Earliest Transaction
(MM/DD/YYYY)
6/9/2016
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(Street)
NEW YORK, NY 10036
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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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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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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Restricted Stock Unit
(1)
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(2)
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6/9/2016
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A
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40016
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(2)
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(2)
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Common Stock
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40016
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$0
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40016
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D
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Stock Option (right to buy)
(1)
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$8.33
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6/9/2016
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A
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182050
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(3)
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10/19/2025
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Common Stock
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182050
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$0
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182050
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D
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Explanation of Responses:
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(
1)
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On October 19, 2015, the registrant's board of directors approved a grant of (i) 182,050 options to purchase shares of the registrant's common stock and (ii) 40,016 restricted stock units, in each case, subject to shareholder approval of the registrant's 2015 Equity Incentive Plan (the "Plan"). The registrant's shareholders approved the Plan on June 9, 2016.
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(
2)
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Each restricted stock unit represents a contingent right to receive one share of the registrant's common stock or the cash value thereof. The restricted stock units will vest ratably on each of the first three anniversaries of October 19, 2015, subject to the reporting person's continued employment with the registrant on each applicable vesting date, to be settled within ten days following the applicable vesting date.
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(
3)
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The stock options will vest ratably on each of the first three anniversaries of October 19, 2015, subject to the reporting person's continued employment with the registrant on each applicable vesting date.
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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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Dean Michael D.
C/O VOLT INFORMATION SCIENCES, INC.
1133 AVENUE OF THE AMERICAS
NEW YORK, NY 10036
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X
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President & CEO
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Signatures
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/s/ Sharon H. Stern, attorney-in-fact
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6/13/2016
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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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