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UNITED STATES 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
FORM 4
[ ] CHECK THIS BOX IF NO LONGER
SUBJECT TO SECTION 16. FORM 4 OR
FORM 5 OBLIGATIONS MAY CONTINUE.
SEE INSTRUCTION 1(b).
(Print or Type Responses)
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OMB Number: 3235-0287
Expires: September 30, 1998
Estimated average burden
hours per response.....0.5
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<S> <C>
1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol
Holmes Charles S. NAI Technologies, Inc. (NATL)
(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for
Number of Reporting Month/Year
117 Whites Lane Person (Voluntary) December 1996
(Street) 5. If Amendment,
Date of Original
Southampton, NY 11968 (Month/Year)
(City) (State) (Zip)
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<S> <C>
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
- ------ -------
- ------ Officer (give ------- Other (specify
title below) below)
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7. Individual or Joint/Group filing (Check Applicable Line)
----- Form filed by One Reporting Person
----- Form filed by More than One Reporting Person
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TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A)
(Instr. 3) action action or Disposed of (D)
Date Code (Instr. 3, 4 and 5)
(Instr. 8)
(Month/ ---------------------------------------------------------------
Day/
Year) (A) or
Code V Amount (D) Price
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<S> <C> <C> <C> <C> <C>
Common Stock, par value $.10 per share 12/09/96 P 30,000 A $3.165
12/10/96 P 20,000 A $3.165
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TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED,
DISPOSED OF, OR BENEFICIALLY OWNED
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5. Amount of 6. Owner- 7. Nature of
Securities ship Indirect
Beneficially Form: Beneficial
Owned at Direct Owner-
End of Month (D) or ship
Indirect
(Instr. 3 and 4) (I)
(Instr. 4) (Instr. 4)
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<S> <C> <C> <C>
By
Common Stock, par value $.10 per share 100,000 I Friend
1,000,000 D
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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 reporting person, see Instruction
4(b)(v).
(Over)
SEC 1474 (7-96)
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FORM 4 (continued)
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TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of Derivative Security 2. Conver- 3. Trans- 4. Trans- 5. Number of Deriv- 6. Date Exer-
(Instr. 3) sion or action action ative Securities Ac- cisable and
Exercise Date Code quired (A) or Dis- Expiration
Price of (Instr. 8) posed of (D) Date
Deri- (Month/ (Instr. 3, 4, and 5) (Month/Day/
vative Day/ Year)
Security Year)
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Date Expira-
Exer- tion
----------------------------------------- cisable Date
Code V (A) (D)
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<S> <C> <C> <C>
Common Stock Warrants Immed- Jan.
(right to buy) $3.00 iate 15/01
Common Stock Warrants Immed- Jan.
(right to buy) $2.50 iate 15/01
Common Stock Options Aug. Aug.
(right to buy) $3.44 7/97 7/06
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TABLE II--DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(e.g., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Nature
Underlying Securities of of Deriv- ship of
(Instr. 3 and 4) Deriv- ative Form of Indirect
ative Secur- Deriv- Benefi-
Secur- ities ative cial
ity Bene- Security: Owner-
(Instr. ficially Direct ship
5) Owned (D) or (Instr. 4)
at End Indirect
------------------------------------ of (I)
Amount or Month (Instr. 4)
Title Number of (Instr. 4)
Shares
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<S> <C> <C> <C> <C>
Common Stock Warrants Common
(right to buy) Stock 300,000 300,000 D
Common Stock Warrants Common
(right to buy) Stock 1,700,000 1,700,000 D
Common Stock Options Common
(right to buy) Stock 5,000 5,000 D
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Explanation of Responses:
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<S> <C> <C>
/s/ Charles S. Holmes 12/17/96
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. ---------------------- -------------
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Date
Reporting Person
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.
Page 2
SEC 1474 (7-96)
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