SEC Form 4 · accession 0001128784-18-000002
VOLT INFORMATION SCIENCES, INC. · VISI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jerome Shaw
10% Owner
Period of report
Mar 18, 2018
Accepted (ET)
Apr 9, 2018 · 6:12 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000103872
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, $0.01 par valueF1,F2 | Mar 18, 2018 | J | 10,000 | $0.00 | D | 0 | I | By Spouse |
| Common Stock, $0.01 par valueF2,F3 | Mar 18, 2018 | J | 1,052,583 | $0.00 | D | 0 | I | Co-Trustees |
| Common Stock, $0.01 par valueF4 | holding | — | — | — | 1,401,547 | I | Trust | |
| Common Stock, $0.01 par value | holding | — | — | — | 22,951 | I | 401K Plan | |
| Common Stock, $0.01 par value | holding | — | — | — | 2,394 | I | ESOP Plan | |
| Common Stock, $0.01 par valueF2,F5 | holding | — | — | — | 12,750 | I | Family Foundation |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Employee Stock Option (Right to Buy)F4,F6 | $6.39 | holding | — | — | — | — | Apr 6, 2019 | Common Stock, $0.01 par value | 8,000 | 8,000 | I |
Explanation of responses
- F1Upon the death of Reporting Person's spouse on 3/18/2018, the shares previously reported by Reporting Person are no longer owned by a member of Reporting Person's Immediate Family living with Reporting Person.
- F2Reporting Person disclaims any beneficial ownership of these shares.
- F3Upon the death of Reporting Person's spouse on 3/18/2018, the trustees of this trust changed. This trust is for the benefit of Reporting Person's adult daughter not living with Reporting Person. Reporting Person is no longer a trustee of this trust. Reporting Person is not and was not a beneficiary of this trust.
- F4Upon the death of Reporting Person's spouse on 3/18/2018, the trustees of this trust changed. Reporting Person is no longer a trustee of this trust. Reporting Person remains the beneficiary of this trust.
- F5Held by a family foundation. Reporting Person is an officer and director of this foundation.
- F6Option vests in 20% annual installments, on a cumulative basis, commencing 4/7/2010, one year after the date of the original grant of the option.