U.S. SECURITIES AND EXCHANGE
FORM 3 Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
20(f) of the Investment Company Act of 1949
<TABLE>
<S> <C>
OMB APPROVAL
-----------------------
OMB Number:
Expires:
Estimated average burden
hours per response... 0.5
- ------------------------------------------------- ---------------------- ----------------------------------------------------------
1. Name and Address of Reporting Person 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol
Requiring Statement
(Month/Day/Year) AVAX Technologies, Inc.
Tousley David L. 7/7/97 AVXT
- ---------------------------------------------
(Last) (First) (Middle)
5. Relationship of Reporting Person 6. If Amendment, Date of
to Issuer (Check all applicable) Original (Month/Day/Year)
12378 Craig
- --------------------------------------------- 3. IRS or Social
(Street) Security Number of
Reporting Person ____ Director ____ 10% Owner
(Voluntary) X Officer
Overland Park, KS 66213 (give title ____ Other (specify -------------------
- -------------------------------------------- below)
(City) (State) (Zip Code) Chief Financial Officer
----------------------------------------
Table I - Non- Derivative Securities Beneficially Owned
- --------------------------------------------------------------------------------------- -------------------------------------------
1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial
(Instr. 4) Beneficially Owned Direct (D) or Indirect (I) Ownership (Instr. 5)
(Instr. 4) (Instr. 5)
- ----------------------------------------------------------------------------------------------------------------------------------
N/A
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
- ----------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Page 1 of 2
<PAGE>
Table II - Derivative Securities Beneficially
Owned (e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<S> <C>
- --------------------------------------------------------------------------------------------------------------------------------
1. Title of Derivative 2. Date 3. Title and Amount of 4. Conversion 5. Ownership 6. Nature of Indirect
Security (Instr. 4) Exercisable and Securities Underlying or Exercise form of Beneficial Ownership
Expiration Date Derivative Security Price of Derivative (Instr. 5)
(Month/Day/ (Instr. 4) Derivative Security: Direct
Year) Security (D) or Indirect
(I) (Instr. 5)
---------------------------------------------
Date Expir- Title Amount or
Exerci ation Number of
sable Date Shares
- -------------------------------------------------------------------------------------------------------------------------------
Non-Statutory Common
Stock Option 1/1/97(1) 10/1/03 Stock 125,000 $1.00 per share D
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
- -------------------------------------------------------------------------------------------------------------------------------
</TABLE>
Explanation of Responses:
(1) The option is exercisable at a rate of 1/16 per quarter over a four-year
period commencing on January 1, 1997. The option expires seven years after
such date.
** Intentional misstatements or omissions of facts constitute Federal
Criminal Violations.
See 18 U.S.C. 1001 and
15 U.S.C. 78ff(a).
/s/ DAVID L. TOUSLEY July 7, 1997
----------------------------------
** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed. If
space provided is insufficient, See Instruction 6 for procedure.
Page 2 of 2
