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OMB APPROVAL
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OMB Number: 3235-8287
Expires: September 30, 1998
Estimated average burden
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Unites States SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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*
Mizerak Joyce S.
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(Last) (First) (Middle)
100 Metroplex Drive, Suite 301
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(Street)
Edison New Jersey 08817
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Hanover Capital Mortgage
Holdings, Inc. HCM
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
August 1999
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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 [_] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
Managing Director + Secretary
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7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[_] 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 118,700 D
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</TABLE>
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).
(Over)
SEC 1474 (7-96)
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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>
9.
Number
of
2. deriv-
Conver- 5. 7. ative
sion Number of Title and Amount Secur-
or Derivative 6. of Underlying 8. ities
Exer- 4. Securities Date Securities Price Bene-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned
1. of action Code of(D) (Month/Day/Year) Amount ative at End
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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Rights to acquire Common Stock 32,500 32,500
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Options (rights to
acquire) Common Stock 43,029 43,029
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Warrants 15.00 3/15/98 9/15/00 Common Stock 5,800 5,800
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Options 4.625 8/29/99 A 35,000 * * Common Stock 35,000 35,000
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</TABLE>
<TABLE>
<CAPTION>
10.
Owner-
ship
Form
of
Deriv- 11.
ative Nature
Secur- of
ity: In-
Direct direct
(D) or Bene-
In- ficial
direct Owner-
(I) ship
(Instr. (Instr.
4) 4)
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<S> <C>
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D
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D
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D
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D
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=================
</TABLE>
Explanation of Responses:
* Grant of options exercisable as follows: 1/3 at 8/29/00, 1/3 at 8/29/01
1/3 at 8/29/02 and shall expire one day less than ten years from grant
date.
/s/ Joyce S. Mizerak 9/10/99
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**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 is insufficient, see Instruction 6 for procedure.
Potential persons who are in 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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SEC 1474 (7-96)
