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- ------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ------------------------------
FORM 4 Washington, D.C. 20549 OMB Approval
- ------------------------- STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ------------------------------
[ ] Check this box if no OMB Number: 3235-0287
longer subject to Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Expires: December 31, 2001
Section 16. Form 4 Section 17(a) of the Public Utility Holding Company Act of 1935 or Estimated average burden
or Form 5 obligations Section 30(f) of the Investment Company Act of 1940 hours per response.......0.5
may continue. See ------------------------------
Instruction 1(b).
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(Print or Type Responses)
<S> <C> <C> <C>
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker 4. Statement for 6. Relationship of Reporting Person(s)
or Trading Symbol Month/Year to Issuer
(Check all applicable)
Evans, Thomas R. Official Payments 11/99 [x] Director [ ] 10% Owner
------------------------------------ Corporation, OPAY [x] Officer (give [ ] Other
(Last) (First) (Middle) title below) (specify below)
Chief Executive Officer
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445 Park Avenue, 10th Floor
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(Street) 3. I.R.S. Identification 5. If Amendment, 7. Individual or Joint/Group Filing
Number of Reporting Date of (Check Applicable Line)
Person, if an entity Original [X] Form Filed by One Reporting Person
New York, New York 10022 (Voluntary) (Month/Year) [ ] Form Filed by More than One
------------------------------------ Reporting Person
(City) (State) (Zip) 11/99
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TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
<S> <C> <C> <C> <C> <C> <C>
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1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) action Code (Instr. or Disposed of (D) Securities Form: Indirect
Date 8) (Instr. 3, 4 and 5) Beneficially Direct (D) Beneficial
(Month/ Owned at End or Indirect Ownership
Day/ of Month (I) (Instr. 4)
Year) (Instr. 3 (Instr. 4)
and 4)
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Code V Amount (A) or (D) Price
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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).
Page 1 of 2
SEC 1475 (3-99)
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FORM 4 (continued)
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TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature of
of sion or action action Derivative Exer- and of of ship Indirect
Deri- Exercise Date Code Securities cisable Amount Deri- Deri- Form Beneficial
vative Price of (Instr. Acquired (A) and Expi- of vative vative of Deri- Ownership
Secu- Deri- (Month/ 8) or Disposed ration Under- Secu- Secu- vative (Instr. 4)
rity vative Day/ of (D) Date lying rity rities Security:
(Instr. Security Year) (Instr. 3, (Month/ Securi- (Instr. Benefi- Direct
3) 4, and 5) Day/ ties 5) cially (D) or
Year) (Instr. Owned Indirect
3 and 4) at End (I)
of (Instr.
Month 4)
(Instr.
4)
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Code V (A) (D) Date Expir- Title Amount
Exerci- ation or
sable Date Number
of
Shares
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Employee $1.33 11/22/99 A V 44,868 Imme 11/22/ Com 44.868 1,370,328 D
Stock d.(1) 2009 mon
Option Stock,
(Right par
to buy) value
$0.01
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Explanation of Responses:
(1) The Right of Repurchase shall lapse, and full vesting will occur,
with respect to 14,956 shares of the Common Stock subject to this Option on
August 26, 2000. Thereafter, the Right of Repurchase shall lapse, and full
vesting will occur, with respect to 1,246 additional shares of the Common Stock
subject to this Option on the last day of each of the next 23 consecutive
calendar months, with the balance of 1,254 shares of Common Stock to vest on the
last day of the 24th consecutive month.
** Intentional misstatements or omissions of
facts constitute Federal Criminal Violations.
See 18 U.S.C. and 15 U.S.C. 78ff(a). By: /S/ Tom Evans 1/4/00
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** Signature of Reporting Person Date
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 to respond to the collection of information contained in this form are not required to respond unless form
displays a currently valid OMB number.
Page 2 of 2
SEC 1475 (3-99)
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