U.S. SECURITIES AND EXCHANGE COMMISSION
Washington D.C. 20549
FORM 3
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 Section 30(f) of the Investment Company Act of 1940
1. Name and Address of Reporting Person*
Rodriguez Karl
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(Last) (First) (Middle)
34700 Pacific Coast Hwy., #303
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(Street)
Capistrano Beach CA 92624
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(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
09/14/99
3. IRS or Social Security Number of Reporting Person (Voluntary)
4. Issuer Name and Ticker or Trading Symbol
Reliant Interactive Media corp. (RIMC)
5. Relationship of Reporting Person to Issuer
(Check all applicable)
|X| Director |_| 10% Owner
|X| Officer (give title below) |_| Other (specify below)
Secretary
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6. If Amendment, Date of Original (Month/Year)
7. Individual of Joint/Group Filing (Check applicable line)
|X| Form Filed by One Reporting Person
|_| Form Filed by More than One Reporting Person
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)
(v)
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
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Table I - Non-Derivative Securities Beneficially Owned
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Amount of Nature of
Securities Ownership Form: Indirect
Title of Beneficially Direct (D) or Beneficial
Security Owned Indirect (I) Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5)
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Common Stock 1,000 D N/A
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<PAGE>
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
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2. Date Exercisable and 3. Title and
Expiration Date Amount of
(Month/Day/Year) Securities
Underlying
Derivative
Security
(Instr. 4)
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5. Owner-
ship Form
of
4. Derivative
Conversion Security: 6. Nature
or Direct (D) of
1. Title of Exercise or Indirect
Derivative Amount or Price of Indirect Beneficial
Security Date Expiration Number of Derivative (I) Ownership
(Instr. 4) Exercisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C>
N/A $ D
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)
(v)
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
<PAGE>
Explanation of Responses:
/s/ Karl E. Rodriguez
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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 provided is insufficient, See Instruction 6 for
procedure.
Alternatively, this form is permitted to be submitted to the
Commission in electronic format at the option of the reporting
person pursuant to Rule 101(b)(4) of Regulation S-T.
