US DATA AUTHORITY INC
4, 2000-09-07
HOTELS & MOTELS
Previous: GENESIS ENERGY LP, PRER14A, 2000-09-07
 Next: BROOKDALE LIVING COMMUNITIES INC, SC 13E3/A, 2000-09-07


FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

OMB APPROVAL
OMB Number: 3235-0104
Expires: October 31, 2001
Estimated average burden hours per response ...0.5

[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.

(Print or Type responses)


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 of Section 30(f) of the Investment Company Act of 1940

 

1. Name and Address of Reporting Person*

Siegel, Melvyn B.
7980 Bayshore Dr.
Margate, NJ 08402)

2. Issuer Name and Ticker or Trading Symbol

US Data Authority, Inc.

6. Relationship of Reporting Person(s) to Issuer

(Check all applicable)

__x__ Director _____ 10% Owner
_____ Officer (give _____ Other (Specify
title below) below)
 _
_

3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary)

4. Statement for
(Month/Year)

8/2000

5. If Amendment,
Date of Original
(Month/Year)

7. Individual or Joint/Group Filing (Check Applicable Line)
___ Form filed by One Reporting Person
_ x_ Form filed by More than One Person

Table I Non-Derivative Securities Beneficially owned

1. Title of Security
(Instr. 3)

2. Tran-saction Date

(Month/Day/
Year)

3. Trans-
action Code

(Instr. 8)

4. Securities Acquired (A)
or Disposed of (D)

(Instr. 3, 4 and 5)

5. Amount of Securities Beneficially Owned at End of Month

(Instr. 3 and 4)

6. Owner-ship Form:
Direct (D) or Indirect (I)

(Instr. 4)

7. Nature of Indirect Beneficial Ownership


(Instr. 4)


Code


V


Amount

(A) or
(D)


Price

Common Stock, $.02 par value

7/5/00

J*

 

760,000

A

n/a

995,000

D

 

Common Stock, $.02 par value

7/5/00

J*

 

575,000

A

n/a

825,000

I

Through Patricia Siegel, wife

Common Stock, $.02 par value

7/5/20

J*

 

290,000

D

n/a

0

I

Through Windforms Venture Capital, LLC

Common Stock, $.02 par value

7/5/20

J*

 

2,250,000

D

n/a

0

I

Through Winspire Venture Capital, LLC

Common Stock, $.02 par value

7/5/20

J*

 

80,980

A

n/a

80,980

I

Siegel#3, LLC

* Windforms Venture Capital , LLC, and Winspire Venture Capital, LLC, were dissolved and their shares were distributed to their members.

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).

 

Potential persons who are to 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

Form 4 (continued) Table II Derivative Securities Acquired, Disposed of, of Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative Security
(Instr. 5)

2. Conver-
sion or
Exercise
Price of
Deri-
vative
Security

3. Trans-
action
Date

(Month/
Day/
Year)

4. Trans-
action
Code
(Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)

6. Date Exercisable and
Expiration
Date
(Month/
Day/
Year)

7. Title and Amount of
Underlying Securities
(Instr. 3 and 4)

8. Price
of
Deriv-
ative
Secur-
ity
(Instr.
5)

9. Number of deriv-
ative
Secur-
ities Bene-
ficially
Owned
at End
of
Month
(Instr. 4)

10. Owner-ship
Form of
Deriv-
ative
Security:
Direct
(D) or
Indirecct
(I)
(Instr. 4)

11 Nature
of
Indirect
Benefi-
cial
Owner-
ship
(Instr.4)


Code


V


(A)


(D)


Date
Exer-
cisable


Expira-
tion
Date


Title


Amount or
number of
Shares

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

 

** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /S/ Melvyn B. Siegel 8-24-200

See 18 U.S.C. 1001 and 15 U.S.C 78ff(a). ** Signature of Reporting Person Date

Note: File three copies of this Form, one of which must be manually signed. If space is

insufficient, See Instruction 6 for procedure.

Potential persons who are to respond to the collection of information contained in this form are not

Required to respond unless the form displays a currently valid OMB Number.



© 2022 IncJournal is not affiliated with or endorsed by the U.S. Securities and Exchange Commission