U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
ANNUAL 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).
[_] Form 3 Holdings Reported.
[_] Form 4 Transactions Reported.
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1. Name and Address of Reporting Person
Ford Chris
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(Last) (First) (Middle)
c/o Warrantech Automotive, Inc.
150 Westpark Way
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(Street)
Euless TX 76040
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Warrantech Corporation - WTEC
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
3/31/00
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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
[_] Officer (give title below) [x] Other (specify below)
President of Warrentech Automotive, Inc.
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7. Individual or Joint/Group Filing
(Check applicable line)
[x] 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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5. 6.
4. Amount of Owner-
Securities Acquired (A) or Securities ship
Disposed of (D) Beneficially Form: 7.
(Instr. 3, 4 and 5) Owned at End Direct Nature of
2. 3. ----------------------------- of Issuer's (D) or Indirect
1. Transaction Transaction (A) Fiscal Year Indirect Beneficial
Title of Security Date Code Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
None
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If the form is filed by more than one Reporting Person, see Instruction 4(6)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses) (Over)
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FORM 5 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
9. 10.
Number Owner-
of ship
2. Deriv- Form of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- Securities Date Securities Price Bene- ity: In-
cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Transac- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of tion Date Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- (Instr. 8) action (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
Option to purchase $3.375 10/18/99 D(1) 28,571 (2) (3) Common 28,571 0 D
common stock Stock
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Explanation of Responses:
(1) Cancellation of option.
(2) Fifty percent of the option would have vested in increments of 5%, 7.5%,
10%, 12.5%, and 15% each year from the first to the fifth of Mr. Ford's
employment anniversary with Warrantech Automotive, Inc. and the remaining
fifty percent would have vested at an annual rate of 10% over the same
period of time, provided that Warrantech Automotive, Inc. would have
achieved at least 20% of each of its net sale revenue and operating income
goals as set forth in the approved budget for each respective fiscal year.
(3) The option would have expired on the fifth year anniversary of the vesting
date.
/s/ Chris Ford 5/12/00
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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.
