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OMB Number: 3235-0145
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THIS DOCUMENT IS A COPY OF THE 13G FILED ON 2/18/97
PURSUANT TO A RULE 201 TEMPORARY HARDSHIP
EXEMPTION.
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. )*
INTERACTION MEDIA CORPORATION
(Name of Issuer)
Common Stock, par value $.005 per share
(Title of Class of Securities)
45638F 10 9
(CUSIP Number)
Check the following box if a fee is being paid with this statement |_|. (A fee
is not required only if the filing person: (1) has a previous statement on file
reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7).
* The remainder of this cover page should be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
Page 1 of 7 Pages
<PAGE>
CUSIP No. 45638F 10 9 13G Page 2 of 7 Pages
- --------------------------------------------------------------------------------
1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Trust under Agreement with Irving R. Burnstine, IRA
- --------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [ ]
(b) [ ]
- --------------------------------------------------------------------------------
3 SEC USE ONLY
- --------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
Florida
- --------------------------------------------------------------------------------
NUMBER OF 5 SOLE VOTING POWER
SHARES 262,409
BENEFICIALLY --------------------------------------------------------------
OWNED BY 6 SHARED VOTING POWER
EACH -0-
REPORTING --------------------------------------------------------------
PERSON 7 SOLE DISPOSITIVE POWER
WITH 262,409
--------------------------------------------------------------
8 SHARED DISPOSITIVE POWER
-0-
- --------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
262,409
- --------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
- --------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
11.7%
- --------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
OO
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT
Page 2 of 7 Pages
<PAGE>
Item 1(a)
Name of Issuer
The issuer of the common stock to which this Schedule 13G relates is
Interaction Media Corporation, a Delaware corporation (the "Company").
Item 1(b)
Address of Issuer's Principal Executive Offices
The Company's principal executive offices are located at 1701 Ponce de Leon
Boulevard, Coral Gables, Florida 33134.
Item 2(a)
Name of Person Filing
This Schedule 13G is filed on behalf of the Trust under Agreement with
Irving R. Burnstine, IRA (the "Trust").
Item 2(b)
Address of Principal Business Office
The Trust's principal business office is located at c/o Northern Trust Bank
of Florida, N.A., 700 Brickell Avenue, Miami, Florida 33131.
Item 2(c)
Citizenship
The Trust is a Florida trust.
Item 2(d)
Title of Class of Securities
The security to which this Schedule 13G relates is the common stock, par
value $.005 per share (the "Common Stock"), of the Company.
Page 3 of 7 Pages
<PAGE>
Item 2(e)
CUSIP Number
The CUSIP number of the Common Stock is 45638F 10 9.
Item 3
If this statement is filed pursuant to Rules 13d-1(b) or 13d-2(b), check whether
the person filing is a:
(a)-(h): Not applicable.
Item 4
Ownership
(a) Amount Beneficially Owned
The Trust beneficially owns 262,409 shares of Common Stock.
(b) Percent of Class
11.7%
(c) Number of Shares as to Which Such Person Has:
(i) Sole Power to Vote or Direct the Vote:
262,409
(ii) Shared Power to Vote or Direct the Vote:
-0-
(iii) Sole Power to Dispose or Direct the Disposition:
262,409
(iv) Shared Power to Dispose or Direct the Disposition of:
-0-
Page 4 of 7 Pages
287609.
<PAGE>
Item 5
Ownership of Five Percent or Less of a Class
Not Applicable
Item 6
Ownership of Five Percent on Behalf of Another Person
The shares owned by the Trust and any dividends thereon are held for the
benefit of Lori Burnstine and Michael L. Burnstine.
Item 7
Identification and Classification of the Subsidiary Which Acquired the Security
Being Reported on By the Parent Holding Company
Not Applicable
Item 8
Identification and Classification of Members of the Group
Not Applicable
Item 9
Notice of Dissolution of Group
Not Applicable
Page 5 of 7 Pages
<PAGE>
Item 10
Certification
After reasonable inquiry and to the best of the my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Dated: February 13, 1997
TRUST UNDER AGREEMENT WITH IRVING
R. BURNSTINE, IRA
By:/s/ Barbara Burnstine
-----------------------------
Barbara Burnstine, Trustee
Page 6 of 7 Pages
<PAGE>
Disclaimer of Beneficial Ownership
Under Rule 13d-4
The filing of the Schedule 13G on behalf of the Trust under Agreement with
Irving R. Burnstine, IRA (the "Trust") does not constitute an admission that the
undersigned is, for the purposes of Section 13(d) or 13(g) of the Securities
Exchange Act of 1934, the beneficial owner of any securities covered by the
Schedule filed on behalf of the tust. Pursuant to Rule 13d-4 of the Securities
Exchange Act of 1934, the undersigned disclaims such ownership with respect to
any shares listed therein of which she would not otherwise be deemed to be the
beneficial owner.
/s/ Barbara Burnstine
---------------------
February 13, 1997
Date
Page 7 of 7 Pages
