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FORM 3 OMB APPROVAL
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OMB Number: 3235-0104
Expires: September 30, 1998
Estimated average burden
hours per response 0.5
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
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
(Print or Type Responses)
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1. Name and Address of Reporting Person
Bishop, Gordon A.
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(Last) (First) (Middle)
c/o OptiCare Health Systems, Inc.
87 Grandview Ave.
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(Street)
Waterbury CT 06708
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
December 1, 1999
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker of Trading Symbol
OptiCare Health Systems, Inc. (OPT)
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[ ] Director
[ ] 10% Owner
[X] Officer (give title below)
[ ] Other (specify below)
President, Buying Group
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6. If Amendment, Date of Original (Month/Day/Year)
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7. Individual or Joint/Group Filing
(Check all applicable)
[X] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
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FORM 3 (continued)
<TABLE>
<CAPTION>
TABLE I--Non-Derivative Securities Beneficially Owned
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1. Title of Security 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial Onwership
(Instr. 4) Beneficially Owned Form: Direct (Instr. 5)
(Instr. 4) (D) or Indirect
(I) (Instr. 5)
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<S> <C> <C> <C>
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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 person, see Instruction 5(b)(v).
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FORM 3 (continued)
<TABLE>
<CAPTION>
TABLE II--Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
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1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conver- 5. Owner- 6. Nature of
Security (Instr. 4) cisable and Underlying Derivative Security sion or ship Indirect
Expiration (Instr. 4) Exercise Form of Beneficial
Date ----------------------------------- Price of Deriv- Ownership
(Month/Day/Year) Deriv- ative (Instr. 5)
--------------------- Amount ative Security
of Security Direct
Date Expira- Title Number (D) or
Exer- tion of Indirect
cisable Date Shares (I)
(Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
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Stock Option 8/13/00 8/13/09 Common Stock 6,250 $5.85 D
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Stock Option 8/13/01 8/13/09 Common Stock 6,250 $5.85 D
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Stock Option 8/13/02 8/13/09 Common Stock 6,250 $5.85 D
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Stock Option 8/13/03 8/13/09 Common Stock 6,250 $5.85 D
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</TABLE>
Explanation of Responses:
/s/ Gordon A. Bishop 11/30/99
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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.
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