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*
Bambrough, Noel Raymond
(Last) (First) (Middle)
670 Tuxedo Place N.W.
(Street)
Atlanta Georgia 30342
(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
May 19, 2000
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary)
###-##-####
4. Issuer Name and Ticker or Trading Symbol
Intacta Technologies Inc. (Trading Symbol: ITAC)
5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
[X] Director [ ] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
Executive Vice President, Chief Operating Officer
---------------
6. If Amendment, Date of Original (Month/Day/Year)
N/A
7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
<TABLE>
<CAPTION>
Table I Non-Derivative Securities Beneficially Owned
2. Amount 3. Ownership
of Secu- Form:
rities Direct 4. Nature of
Bene- (D) or Indirect
Ficially Indirect Beneficial
Owned (I) Ownership
1. Title of Security (Instr. 4) (Instr. 5) (Instr. 5)
----------------------- ------------- -------------- ---------------
<S> <C> <C> <C>
Common Stock 1,000 D
Common Stock 1,000 I As Custodian for daughter
Common Stock 1,000 I By daughter
Reminder: Report on a separate line for each class of securities benefically
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
5(b)(v).
Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB control number.
</TABLE>
<PAGE>
<TABLE>
<CAPTION>
Table II Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
2. Date Exercisable
and Expiration Date 3. Title and Amount of Securities Underlying Derivative
(Month/Day/Year) Security (Instr. 4)
----------------------- ----------------------------------------------------
Date Amount or
1. Title of Derivative Exercis- Expiration Title number of
Security (Instr. 4) able Date Shares
---------------------- ----------------------- ----------------------------------------------------
<S> <C> <C> <C> <C>
Employee Stock Option* June 1, March 31, Common share 50,000
(right to buy) 2000 2002
Employee Stock Option June 1, March 31, Common share 150,000
(right to buy)
<CAPTION>
5. Ownership
Form of
Derivative
4. Conver- Security:
sion or Direct 6. Nature of
Exercise (D) Indirect
Price of Indirect Beneficial
1. Title of Derivative Derivative (I) Ownership
Security (Instr. 4) Security (Instr. 5) (Instr. 5)
---------------------- ------------------- ------------- -------------
<S> <C> <C> <C>
Employee Stock Option* $4.00 D
(right to buy)
Employee Stock Option $4.00 D
(right to buy)
</TABLE>
Explanation of Responses:
* 50,000 shall vest/may be exercised after the closing date of an initial public
offering of a minimum of 1 million shares
/s/ Noel Bambrough 6/1/00
------------------------------- ------------
**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 to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB number.
