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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
Rella William
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(Last) (First) (Middle)
13355 SW 16th Court, Apt 309
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(Street)
Pembroke Pines, FL 33027
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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
January, 1997
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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)
[ ] Director
[ ] 10% Owner
[X] Officer (give title below)
[ ] Other (specify below)
President-Fulfillment Services
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7. Individual or Parent/Group Filing (Check Appropriate Line)
[X] Form filed for One Reporting Person
[ ] Form filed by More Than One Reporting Person
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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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</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 86,629* 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 2.61
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Incentive Stock Option 2.61 3/11/96 X 44,000
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Incentive Stock Option 13.75
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Incentive Stock Option 13.75 1/9/97 J 40,000
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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 Note 1 3/25/03 Common Stock 132,000
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Incentive Stock Option Note 1 3/25/03 Common Stock
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Incentive Stock Option Note 2 9/15/05 Common Stock 80,000
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Incentive Stock Option Note 2 9/15/05 Common Stock
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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 88,000 D
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Incentive Stock Option
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Incentive Stock Option 40,000 D
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</TABLE>
Explanation of Responses:
J Cancelled
*Previously reported
Note 1 20% in 93, 94, 95, 96 and 97
Note 2 25% in 96, 97, 98 and 99
/s/William Rella 2/10/97
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Signature of Reporting Person Date
