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F O R M 4
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person
Cohen Marvin
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(Last) (First) (Middle)
82 Battel Place
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(Street)
Oradell, NJ 07649
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(City) (State) (Zip)
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2. Issuer Name and Ticker of Trading Symbol
LCS INDUSTRIES, INC. (LCSI)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
###-##-####
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4. Statement for Month/Year
November, 1996
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer (Check all applicable)
[X] Director
[ ] 10% Owner
[X] Officer (give title below)
[ ] Other (specify below)
Senior Vice President
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<PAGE>
<TABLE>
<CAPTION>
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TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENFICIALLY OWNED
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1. Title of Security (Instr. 3) 2. Transaction Date 3. Transaction Code 4. Securities Acquired (A)
(Month/Day/Year) (Instr. 8) or Disposed of (D)
(Instr. 3, 4 and 5)
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(A) or
Code V Amount (D) Price
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<S> <C> <C> <C> <C> <C> <C>
Common Stock, par value $.01/share
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Common Stock, par value $.01/share 11/06/96 M 66,000 A 2.25
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</TABLE>
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<TABLE>
<CAPTION>
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TABLE I -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENFICIALLY OWNED -- Continued
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1. Title of Security (Instr. 3) 5. Amount of Securities 6. Ownership Form: 7. Nature of Indirect
Beneficially Owned Direct (D) or Beneficial
(Instr. 4) Indirect (I) Ownership
(Instr. 4) (Instr. 4)
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<S> <C> <C> <C>
Common Stock, par value $.01/share 270,736*
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Common Stock, par value $.01/share 336,736 D
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</TABLE>
*Previously Reported
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<TABLE>
<CAPTION>
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TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTION, CONVERTIBLE SECURITIES)
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1. Title of Derivative Security 2. Conversion 3. Transaction Date 4. Transaction Code 5. Number of Derivative
(Instr. 3) Or Exercise (Month/Day/Year) (Instr. 8) Securities Acquired (A)
Price of or Disposed of (D)
Derivative (Instr. 3, 4, and 5)
Security
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Code V (A) (D)
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<S> <C> <C> <C> <C> <C> <C>
Incentive Stock Option 2.25 11/6/96 X 66,000
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*Incentive Stock Option 2.69
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*Incentive Stock Option 3.25
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*Common Stock Option 5.75
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*Incentive Stock Option 16.85
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</TABLE>
<TABLE>
<CAPTION>
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TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTION, CONVERTIBLE SECURITIES) -- Continued
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1. Title of Derivative Security 6. Date 7. Title and 8. Price of
(Instr. 3) Exercisable Amount of Derivavtive
and Underlying Security
Expiration Securities (Instr. 5)
Date (Month/ (Instr. 3
Day/Year) and 4)
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Date Expira- Amount or
Exer- tion Number
cisable Date Title of Shares
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<S> <C> <C> <C> <C> <C>
Incentive Stock Option 11/7/91 11/6/96 Common Stock
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*Incentive Stock Option 11/9/92 11/8/97 Common Stock 22,000
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*Incentive Stock Option 1/3/94 1/2/99 Common Stock 11,000
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*Common Stock Option 2/6/95** 2/5/05 Common Stock 25,000
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*Incentive Stock Option 9/6/95 9/6/00 Common Stock 50,000
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</TABLE>
<PAGE>
<TABLE>
<CAPTION>
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TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTION, CONVERTIBLE SECURITIES) -- Continued
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1. Title of Derivative Security 9. Number of Derivative 10. Ownership Form of 11. Nature of Indirect
(Instr. 3) Securities Beneficially Derivative Security: Beneficial
Owned at End of Month Direct (D) or Ownership
(Instr. 4) Indirect (I) (Instr. 4) (Instr. 4)
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<S> <C> <C> <C>
Incentive Stock Option
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*Incentive Stock Option 22,000 D
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*Incentive Stock Option 11,000 D
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*Common Stock Option 25,000 D
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*Incentive Stock Option 50,000 D
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</TABLE>
Explanation of Responses:
*Previously reported on Form 4
**Pending shareholder approval
/s/Marvin Cohen 12/9/96
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Signature of Reporting Person Date
