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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
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1. Name and Address of Reporting Person*
SHALOM-BEN DOR, GIDEON
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(Last) (First) (Middle)
21C YEGIA KAPAYIM ST KIRYAT-ARIE
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(Street)
PETACH-TIKVA, ISRAEL 49130
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(City) (State) (Zip)
11/19/99
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2. Date of Event Requiring Statement (Month/Day/Year)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
GOURMETMARKET.COM, INC. (WINE)
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4. Issuer Name and Ticker or Trading Symbol
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5. Relationship of Reporting Person to Issuer (Check all applicable)
[ X ] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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6. If Amendment, Date of Original (Month/Day/Year)
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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 Beneficially Owned
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<TABLE>
<CAPTION>
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1. Title of Security | 2. Amount of Securities | 3. Ownership Form: | 4. Nature of Indirect Beneficial
(Instr. 4) | Beneficially Owned | Direct (D) or Indirect | Ownership (Instr. 4)
| (Instr. 4) | (I) (Instr. 5) |
<S> <C> <C> <C>
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Common Stock, | 1,215,000 | D |
$.001 par value | | |
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</TABLE>
Reminder: Report on a seperate line for each class of securities beneficially
owned directly or indirectly.
(Over)
SEC 1473 (3-99)
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FORM 3 (continued) Table II -- Derivative Securities Benefically Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
<S> <C>
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date
| (Month/Day/Year)
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| Date Exercisable | Expiration Date
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3. Title and Amount of Securities | 4. Conversion or Exercise | 5. Ownership Form of Derivative | 6. Nature of Indirect
Underlying Derivative Security | Price of Derivative | Security: Direct (D) or | Beneficial Ownership
(Instr. 4) | Security | Indirect (I) (Instr. 5) | (Instr. 5)
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| Amount or | | |
| Number of | | |
Title | Shares | | |
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</TABLE>
Explanation of Responses:
/s/ Gideon Shalom Ben Dor 11/20/99
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GIDEON SHALOM BEN DOR Date
** Signature of Reporting Person
** 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.
