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FORM 4
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
[_] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Commonwealth Associates, LP
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(Last) (First) (Middle)
830 Third Avenue
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(Street)
New York New York 10022
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Intelispan, Inc. (NASD OTCBB: IPVN)
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3. IRS or Social Security Number of Reporting Person, if an entity (Voluntary)
13-3467952
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4. Statement for Month/Year
September 2000
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[x] Director [x] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
Michael S. Falk is a director
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7. Individual or Joint/Group Filing (Check Applicable Line)
[_] Form filed by One Reporting Person
[x] Form filed by More than One Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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<TABLE>
<CAPTION>
6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (Month/Day/Year) Code V (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Common Stock 09/12/00 X 8,968,367 A $.50 7,907,321 D(1)
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Common Stock 09/12/00 X 66,667 A $.50 9,441,667 I (2)
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Common Stock 09/12/00 X 4,017,927 A $.50 4,049,018 I (3)
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Common Stock 09/12/00 X 16,667 A $.50 47,917 I (4)
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Common Stock 09/12/00 X 1,121,046 D $4.00 7,907,321 D(1)
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Common Stock 09/12/00 X 8,334 D $4.00 9,441,667 I (2)
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Common Stock 09/12/00 X 502,241 D $4.00 4,049,018 I (3)
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Common Stock 09/12/00 X 2,083 D $4.00 47,917 I (4)
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</TABLE>
(Over)
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FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Warrants to Purchase 12/06-
Common Stock $.50 9/12/00 X 8,968,367 immed 01/07 Common Stock 8,968,367 0 D(1)
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Warrants to Purchase
Common Stock $.50 9/12/00 X 66,667 immed 12/04 Common Stock 66,667 0 I (2)
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Warrants to Purchase 12/04-
Common Stock $.50 9/12/00 X 4,017,927 immed 12/06 Common Stock 4,017,927 0 I (3)
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Warrants to Purchase 12/04-
Common Stock $.50 9/12/00 X 16,667 immed 12/06 Common Stock 16,667 0 I (4)
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Explanation of Responses:
</TABLE>
/s/ /s/ Joseph P. Wynne September 25,2000
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**Signature of Reporting Person Date
Joseph P. Wynne, Chief Financial Officer
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).
** 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.
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FOOTNOTES Page 3 of 4
(1) These shares acquired are owned directly by, and these shares and warrants
disposed of were owned directly by, Commonwealth Associates, L.P.
("Commonwealth") . Michael S. Falk ("Falk") is the principal limited partner of
Commonwealth, and is a director, the Chairman and the principal shareholder of
Commonwealth Associates Management Corp., the general partner of Commonwealth.
Falk disclaims beneficial ownership of the securities held by Commonwealth other
than that portion which corresponds with his equity ownership in Commonwealth.
(2) These shares acquired are owned directly by, and these shares and warrants
disposed of were owned directly by, ComVest Capital Partners LLC ("ComVest").
Falk is a manager and the principal member of ComVest. Falk disclaims beneficial
ownership of the shares held by ComVest other than that portion which
corresponds with his membership interest in ComVest.
(3) These shares acquired are owned directly by, and these shares and warrants
disposed of were owned directly by, Falk.
(4) These shares acquired are owned directly by, and these shares and warrants
disposed of were owned directly by, trusts for the benefit of Falk's children.
Falk is the trustee of such trusts.
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JOINT FILER INFORMATION AND AUTHORIZATION Page 4 of 4
Name: Commonwealth Associates Management Corp.
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates, LP
Issuer & Ticker Symbol: Intelispan, Inc. (IPVN)
Statement Month/Year: September 2000
Signature: By: /s/ Joseph Wynne
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Joseph Wynne, Chief Financial Officer
Name: ComVest Capital Partners LLC
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates, LP
Issuer & Ticker Symbol: Intelispan, Inc. (IPVN)
Statement Month/Year: September 2000
Signature: By: /s/ Michael S. Falk
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Michael S. Falk, Manager
Name: Michael S. Falk
830 Third Avenue
New York, New York 10022
Designated Filer: Commonwealth Associates, LP
Issuer & Ticker Symbol: Intelispan, Inc. (IPVN)
Statement Month/Year: September 2000
Signature: /s/ Michael S. Falk
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Michael S. Falk