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- ---------------- U.S. SECURITIES AND EXCHANGED COMMISION
- ----------------------------
|F O R M 5| Washington, D.C. 20549 |OMB APPROVAL |
|--------------------------|
Check this box if ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0362|
[ ] no longer Subject |Expires:September 30,1998|
to Section 16.
|Estimated ave. burden |
|hours per response.....1.0|
[x] Form 3 Holdings Rep. 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
[X] Form 4 Trans. Rep. Section 30(f) of the Investment Company Act 1940
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Name and Address of Reporting Person* |2.Issuer Name and Ticker or Trading Symbol |6.Relationship of Reporting Person to |
| | | Issuer (Check all
Applicable) |
| Micek Greg V. | JVWeb, Inc. "JVWB" |[X] Director [X] 10% Owner |
[X] Officer
|----------------------------------------|------------------------------------------------|---
|
| (Last) (First) (MI)|3.IRS or Soc. Sec. No. |4.Statement for Month/ | Other |
| | of Reporting Person | Year |---(give title below)
- ---(Specify below)|
| | (Voluntary) |
| |
| 5444 Westheimer, Suite 2080 | | October, 1999 |President |
| | |
| |
|----------------------------------------|
|------------------------|----------------------------------------|
| (Street) | |5.If Amendment, Date of |7. Individual or
Joint/Group Filing |
| | | Original (Month/Year) | (Check Applicable Line) |
| | | |
| | | | x Form filed by One Reporting Person |
| | |
|--- |
| Houston Texas 77056 | | | Form filed by More than One |
| | | | --- Reporting Person |
|----------------------------------------------------------------------------------------------------------------------------------|
| (City) (State)
(Zip) |
| TABLE I - Non-Derivative Securities Acquired, Disposed of or
Beneficially Owned |
|----------------------------------------------------------------------------------------------------------------------------------|
|1.Title of Security |2.Transac- |3.Trans. |4.Security Acquired (A) or |5.Amount of |6. |7.Nature of Indirect|
| (Instr. 3) | tion Date | Code | Disposed of (D) | Securities |Own.| Beneficial |
| |(Mon/Day/Yr)|(Instr.8)| (Instr. 3, 4 & 5) | Beneficially |Form| Ownership |
| | | | | Owned at End of|(D) | (Instr. 4) |
| | | |-------------------------------| Issuer's |or | |
| | | | |(A) | | Fiscal Year |(I) | |
| | | | Amount |(D) | Price | (Instr. 3 & 4) | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C>
|<C> |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
|Common stock, par value $.001 | | | | | | |
| | 6/30/99 | |300,000 | D | * | 5,750,000 | D | |
| |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
* The shares were exchanged for outstanding promissory notes held against the
issuer having an aggragate principal amount of $200,000 or $0.667 per share
exchanged.
Reminder: Report on a separate line for each class securities owned directly or
indirectly. SEC 2270 (7-97)
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
PAGE: 1 OF 2
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FORM 5 (continued) TABLE II - Derivative
Securities Acquired, Disposed of,
Beneficially Owned (e.g., puts, calls,
warrants, options, convertible security)
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Title of|2.Conver-|3. |4.Tran- |5.Number of |6.Date |7.Title and Amount |8.Price of|9.Number |10. |11.Nature |
|Derivative|sion or |Trans| saction| Derivative |Exercisable| of Underlying |Derivative|of |Own.| of |
|Security |Exercise |Date | Code | Securities |and | Securities |Security |Derivative|Form|Indirect |
|(Instr. 3)|Price of |(Mon/|(Instr.8)| Acquired (A) or |Expiration | (Instr. 3 & 4) |(Instr. 5)|Securities|of |Beneficial|
| |Deriva- | Day/| | Disposed of (D) |Date | | |Benefi- |Deri|Ownership |
| |tive |Year)| | (Instr. 3, 4 & 5) |(Month/Day/| | |cially |Sec.|(Instr. 4)|
| |Security | | | | Year) | | |Owned at |Dir.| |
| | | | | |-----------|---------------------| |End of |(D) | |
| | | | | | | | |Amount or | |Year |or | |
| | | | |---------------------|Date |Exp. | Title |Number of | |(Instr. 4)|Ind.| |
| | | | | (A) | (D) |Exbl.|Date | |Shares | | |(I) | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C>
|<C> |<C> |<C> |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
| | | | | | | | | | | | | |
|Common | | | | 300,000 | |Now |11/30| |2,000,000 | |2,000,000 | D | |
| Option | | | | | | | /02 | | | | | | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
| | | | | | | | | | | | | | |
| | | | | | | | | | | | | | |
| | | | | | | | | | | | | | |
| | | | | | | | | | | | | | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
| | | | | | | | | | | | | | |
| | | | | | | | | | | | | | |
| | | | | | | | | | | | | | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
Explanation of Responses:
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
/s/ Greg V. Micek 10/13/1999
- -------------------------------------- ----------
**Signature of Reporting Person Date
Note: File three copies of this form, one of which must be manually signed.
If space provided is insufficient, see Instruction 6 for
procedure. SEC 2270 (7-97)
Potential persons who are to respond to the collections of information contained
in this form are not required to respond unless the form displays a currently
valid OMD Number
PAGE: 2 OF 2
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