SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: MAS ACQUISITION I CORP. /DE/
CENTRAL INDEX KEY: 0001022409
STANDARD INDUSTRIAL CLASSIFICATION: []
IRS NUMBER: 35-1990509
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 000-28772
FILM NUMBER:
BUSINESS ADDRESS:
STREET 1: 1922 North Bedford Ave.
CITY: Evansville
STATE: IN
ZIP: 47711
BUSINESS PHONE: 812-468-8250
MAIL ADDRESS:
STREET 1: 1922 North Bedford Ave.
CITY: Evansville
STATE: IN
ZIP: 47711
REPORTING-OWNER:
COMPANY DATA:
COMPANY CONFORMED NAME: Aaron Tsai
CENTRAL INDEX KEY:
STANDARD INDUSTRIAL CLASSIFICATION: []
RELATIONSHIP: OFFICER, DIRECTOR AND 10% OWNER
FILING VALUES:
FORM TYPE: 5
BUSINESS ADDRESS:
STREET 1922 North Bedford Ave.
CITY: Evansvile
STATE: IN
ZIP: 47711
BUSINESS PHONE: 812-468-8250
[DESCRIPTION]ANNUAL STATEMENT OF CHANGES
IN BENEFICIAL OWNERSHIP
<PAGE>
FORM 5
/ / Check box if no longer OMB APPROVAL
subject to Section 16. OMB NUMBER: 3235-0362
Form 4 or Form 5 EXPIRES: SEPTEMBER 30, 1998
obligations may continue. ESTIMATED AVERAGE BURDEN
See Instruction 1(b) HOURS PER RESPONSE 1.0
/ / Form 3 Holdings Reported
/ / Form 4 Transactions Reported
U.S. SECURITIES AND EXCHANGE
COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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*
Tsai Aaron
(Last) (First) (Middle)
1103 Landing Meadows Dr.
(Street)
Henderson KY 42420
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MAS Acquisition I Corp.
(Common Stock: No Trading Symbol)
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Statement for Month/Year
12/96
5. If Amendment, Date of Original (Month/Year)
6. Relationship of Reporting Person(s) to Issuer (Check all applicable)
( V ) Director ( V ) 10% Owner
( V ) Officer (give title below) ( ) Other (specify below)
President, Chief Executive Officer and Treasurer
7. Individual or Joint/Group Filing (Check applicable line)
( V ) Form filed by One Reporting Person
( ) Form filed by More than One Reporting Person
* If Form is filed by more than one Reporting Person, see Instruction 4(b)(v).
(Print or Type Responses) Page 1
<PAGE>
<TABLE>
<CAPTION>
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security 2. Transaction Date
(Instr. 3) (Month/Day/Year)
- - ------------------------------------- -----------------------
<S> <C>
a. Common Stock, par value $.001 08/15/1996
- - ------------------------------------- -----------------------
b.
- - ------------------------------------- -----------------------
c.
- - ------------------------------------- -----------------------
d.
- - ------------------------------------- -----------------------
e.
- - ------------------------------------- -----------------------
f.
- - ------------------------------------- -----------------------
3. Transaction 4. Securities Acquired (A) or
Code Disposed of (D)
(Instr. 8) (Instr. 3, 4 and 5)
-------------------------------------------
Amount (A) or (D) Price
- - ----------------- ------------- ------------- -------------
<S> <C> <C> <C>
a. P 8,500,000 A $8,500
- - ----------------- ------------- ------------- -------------
b.
- - ----------------- ------------- ------------- -------------
c.
- - ----------------- ------------- ------------- -------------
d.
- - ----------------- ------------- ------------- -------------
e.
- - ----------------- ------------- ------------- -------------
f.
- - ----------------- ------------- ------------- -------------
<CAPTION>
5. Amount of Securities 6. Ownership Form: 7. Nature of Indirect
Benificially Owned Direct (D) or Beneficial Ownership
at End of Issuer's Fiscal Indirect (I) (Instr. 4)
Year (Instr. 4)
(Instr. 3 and 4)
- - ----------------------------- ------------------ -----------------------
<S> <C> <C>
a. 8,500,000 I By MAS Financial Corp.
- - ----------------------------- ------------------ -----------------------
b.
- - ----------------------------- ------------------ -----------------------
c.
- - ----------------------------- ------------------ -----------------------
d.
- - ----------------------------- ------------------ -----------------------
e.
- - ----------------------------- ------------------ -----------------------
f.
- - ----------------------------- ------------------ -----------------------
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
</TABLE>
(Print or Type Responses) Page 2
<PAGE>
<TABLE>
<CAPTION>
Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned
(e.g, puts, calls, warrants, options, convertible securities)
1. Title of 2. Conver- 3. Transac- 4. Transac- 5. Number of
Derative sion or sion sion Derivative
Security Exercise Date Code Securities
(Instr. 3) Price (Month/ Acquired (A) or
of Day/ (Instr. 8) Disposed of (D)
Derivative Year) (Instr. 3, 4 and 5)
Security --------------------
(A) (D)
- - ------------ -------------- ---------- ------------- --------- ----------
<S> <C> <C> <C> <C> <C>
a.
- - ------------ -------------- ---------- ------------- --------- ----------
b.
- - ------------ -------------- ---------- ------------- --------- ----------
c.
- - ------------ -------------- ---------- ------------- --------- ----------
d.
- - ------------ -------------- ---------- ------------- --------- ----------
e.
- - ------------ -------------- ---------- ------------- --------- ----------
f.
- - ------------ -------------- ---------- ------------- --------- ----------
<CAPTION>
6. Date Exercisable 7. Title and Amount of Underlying 8. Price of
and Expiration Securities Derivative
Date (Instr. 3 and 4) Security
(Month/Day/Year) (Instr. 5)
- - --------------------------- ---------------------------------
Date Expiration Title Amount or
Exercisable Date Number of
Shares
- - --------------- ----------- ----------------- -------------- -------------
<S> <C> <C> <C> <C>
a.
- - --------------- ----------- ----------------- -------------- -------------
b.
- - --------------- ----------- ----------------- -------------- -------------
c.
- - --------------- ----------- ----------------- -------------- -------------
d.
- - --------------- ----------- ----------------- -------------- -------------
e.
- - --------------- ----------- ----------------- -------------- -------------
f.
- - --------------- ----------- ----------------- -------------- -------------
9. Number of 10. Ownership 11. Nature of
Derivative of Deriva- Indirect
Securities tive Beneficial
Beneficially Security: Ownership
Owned at Direct (D) (Instr. 4)
End of Year or Indirect
(Instr. 4) (I) (Instr. 4)
- ------------------- -------------------- -----------------
<S> <C> <C>
a.
- ------------------- -------------------- -----------------
b.
- ------------------- -------------------- -----------------
c.
- ------------------- -------------------- -----------------
d.
- ------------------- -------------------- -----------------
e.
- ------------------- -------------------- -----------------
f.
- ------------------- -------------------- -----------------
</TABLE>
Explanation of Responses:
(1) The options were all granted on October 1, 1996 under the issuer's 1996
stock option plan and have 10 year terms (unless the reporting
person's employment with the issuer terminates earlier). 20% of
the options become exercisable on each of the 1st, 2nd, 3rd, 4th
and 5th anniversaries of the date of grant.
/s/ Aaron Tsai June 18, 1997
- - ------------------------------- ----------------------
** Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
(Print or Type Responses) Page 3
