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-------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION
FORM 3 WASHINGTON, D.C. 20549
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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
(Print or Type Responses) Section 30(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person* 2. Date of Event Re- 4. Issuer Name AND Ticker or Trading Symbol
Connolly, Jr. Edward M. quiring Statement EPIQ Systems, Inc. "EPIQ"
------------------------------------- (Month/Day/Year)
(Last) (First) (Middle) 1-9-01
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3. IRS or Identifi- 5. Relationship of Reporting Person(s) 6. If Amendment, Date
501 Kansas Avenue cation Number of to Issuer (Check all applicable) of Original
----------------- Reporting Person, X Director 10% Owner (Month/Day/Year)
(Street) Person, if an entity --- ----
Kansas City Kansas 66105 (voluntary) Officer (give Other (specify ---------------------
------------------------------------------- title below) below) 7. Individual or
(City) (State) (Zip) --- ---- Joint/Group Filing
(Check Applicable
Line)
Form filed by One
X Reporting Person
---
Form filed by
More than One
Reporting Person
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TABLE I -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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1. Title of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial
(Instr. 4) Beneficially Owned Form: Direct Ownership (Instr. 5)
(Instr. 4) (D) or Indirect
(I) (Instr. 5)
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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 5(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.
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FORM 3 (CONTINUED) TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE
SECURITIES)
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1. Title of Derivative Security 2. Date Exer- 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of Indirect
(Instr. 4) cisable and Underlying Derivative Security sion or ship Beneficial
Expiration (Instr. 4) Exercise Form of Ownership
Date Price of Deriv- (Instr. 5)
(Month/Day/ Deri- ative
Year) vative Security:
-------------------------------------------------- Security Direct
Amount (D) or
Date Expir- or Indirect
Exer- ation Title Number (I)
cisable Date of
Shares (Instr. 5)
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Option to Buy * 1-9-11 Common Stock 7,500 $17.25 D
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Explanation of Responses:
*Vests 20% per year, over a 5-year period.
/s/ Edward M. Connolly, Jr. January 17, 2001
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**Intentional misstatements or omissions of facts constitute Federal **Signature of Reporting Person Date
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 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.
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