U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
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
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1. Name and Address of Reporting Person*
Brentlinger Charles Jayson
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(Last) (First) (Middle)
8402 East Jenan Drive
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(Street)
Scottsdale Arizona 85260
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
June 28, 1999
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
Circuit Research Labs, Inc. (CRLI)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[_] Director [_] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
President and CEO
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6. If Amendment, Date of Original (Month/Day/Year)
N/A
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form Filed by 1 Reporting Person
[_] Form Filed by More than 1 Reporting Person
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Table I -- Non-Derivative Securities Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4)
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<S> <C> <C> <C>
Common Stock $.10 par Value See Note See Note See Note
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Over)
SEC 1473 (3-99)
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FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
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Option to purchase See Note See Note Common Stock 500,000 $2.50 See Note See Note
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5000,000 shares of
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Company's stock
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Explanation of Responses:
/S/ Charles Jayson Brentlinger July 7, 1999
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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 provided is insufficient, see Instruction 6 for procedure.
Page 2
Table 1 (Note)
Mr. Brentlinger currently owns no shares of the issuer. He has entered into a
Stock Purchase Agreement by which he has agreed to purchase, subject to the
terms and conditions contained therein, the following shares, (i) 187,500
shares of common stock from the Company. $300,00 has been paid and the
balance of $271,875 will be paid at closing; (ii) 121,312 shares of common
stock from the President of the Company, Gary Clarkson, which purchase price
is to be paid $250,000 cash at closing and the balance to be deferred; 171,250
shares from the Company with the purchase price of $428,125 to be paid within
one year of closing. Subject to the customary conditions, the closing date
will be no later than September 30, 1999.
Table II (Note)
Mr. Brentlinger has entered into a stock purchase agreement with the Company.
Upon the closing of this agreement, Mr. Brentlinger will receive an option to
purchase up to 500,000 shares of the Company's common stock at the price of
$2.50 per share. Subject to the customary conditions, the closing date will
be no later than September 30, 1999. The option will expire 5 years from the
closing date.
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the intormation set forth in this statement is true, complete
and correct.
July 7, 1999
/s/ Charles Jayson Brentlinger
Charles Jayson Brentlinger
Attention: Intentional misstatements or omissions of fact
constitute federal criminal violations (see 18 U.S.C. 1001)
