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OMB APPROVAL
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OMB Number: 3235-0145
Expires: December 31, 1997
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(Amendment No. 18 )*
Jaclyn, Inc.
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(Name of Issuer)
Common Stock, par value $1.00 per share
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(Title of Class of Securities)
469772 10 7
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(CUSIP Number)
Check the following box if a fee is being paid with the statement [_]. (A fee is
not required only if the filing person: (1) has a previous statement on file
reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7).
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter the
disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
SEC 1745 (2-95)
Page 1 of 3 pages
<PAGE>
13G
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CUSIP No. 469772 10 7 Page 2 of 3 Pages
- ------------------------ -----------------
================================================================================
1 NAME OF REPORTING PERSON
S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON
Bonnie Sue Levy
- --------------------------------------------------------------------------------
2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) [_]
(b) [_]
- --------------------------------------------------------------------------------
3 SEC USE ONLY
- --------------------------------------------------------------------------------
4 CITIZENSHIP OR PLACE OF ORGANIZATION
United States
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5 SOLE VOTING POWER
0
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NUMBER OF 6 SHARED VOTING POWER
SHARES
BENEFICIALLY 0
OWNED BY
EACH --------------------------------------------------
REPORTING 7 SOLE DISPOSITIVE POWER
PERSON
WITH 220,626
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8 SHARED DISPOSITIVE POWER
0
- --------------------------------------------------------------------------------
9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
220,626
- --------------------------------------------------------------------------------
10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES*
[_]
- --------------------------------------------------------------------------------
11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9
8.2%
- --------------------------------------------------------------------------------
12 TYPE OF REPORTING PERSON*
IN
- --------------------------------------------------------------------------------
*SEE INSTRUCTIONS BEFORE FILLING OUT!
SEC 1745 (2-95)
Page 2 of 3 pages
<PAGE>
13G
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CUSIP No. 469772 10 7 Page 3 of 3 Pages
- ------------------------ -----------------
Except as to Item 4, no change has occurred with respect to the answer
to any items of this Schedule from the information last reported in respect of
such item.
Item 4. Ownership. As of December 31, 1996:
(a) Amount beneficially owned:
220,626 shares of Common Stock. This amount includes 4,322 shares
allocated to Mrs. Levy's account under the Jaclyn, Inc. Employee Stock
Ownership Plan and 12,500 shares which Mrs. Levy may acquire purusant
to presently exercisable stock options.
(b) Percent of Class: 8.2%
(c) Number of shares as to which such person has:
(i) sole power to vote or direct the vote: none
(ii) shared power to vote or direct the vote: none
(iii) sole power to dispose or direct the disposition of:
220,626
(iv) shared power to dispose or direct the disposition of:
none
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
February 13, 1997
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Date
/s/ Bonnie Sue Levy
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Signature
Bonnie Sue Levy, Vice President
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Name/Title
SEC 1745 (2-95)
Page 3 of 3 pages
