FORM 3
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
OMB APPROVAL
OMB Number: 3235-0104
Expires: September 30, 1998
Estimated average burden
hours per response . . . . 0.5
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 Persons
Earl Gallegos
c/o Cover-All Technologies Inc.
18-01 Pollitt Drive
Fair Lawn, New Jersey 07410
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2. Date of Event Requiring Statement
(Month/Day/Year)
3/14/1997
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
COVER-ALL TECHNOLOGIES INC. (COVR)
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
X Director 10% Owner
---- ----
Officer Other (specify below)
---- (give ----
title
below)
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6. If Amendment, Date of
Original (Month/Day/Year)
3/14/97
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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 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
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Title of Security 2. Amounts of 3. Ownership 4. Nature of
(Instr. 4) Securities Form: Direct (D) Indirect
Beneficially or Indirect (I) Beneficial
Owned (Instr. 5) Ownership
(Instr. 4) (Instr. 5)
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None
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(Print or Type Responses)
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
5(b)(v).
(over)
SEC 1473 (7-96)
<PAGE>
FORM 3 (CONTINUED)
TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS,
CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. Title of 2. Date Exer- 3. Title and Amount of
Derivative cisable and Securities Underlying
Security Expiration Derivative Security
(Instr. 4) Date (Instr. 4)
(Month/Day/
Year)
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Date Expira- Amount
Exer- tion Title or
cisable Date Number
of
Shares
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Stock Options Common
(right to buy) * Stock 237,500
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Stock Options Common
(right to buy) 9/14/97 3/14/02 Stock 10,000
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4. Conver- 5. Ownership 6. Nature of
sion or Form of Indirect
Exercise Derivative Beneficial
Price of Security: Ownership
Deri- Direct (Instr. 5)
vative (D) or
Security Indirect
(I)
(Instr. 5)
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$1.25 D
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$2.13 D
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Explanation of Responses:
* The options become exercisable at the rate of 25,000 per month;
12,500 for the period March 14th through March 31st, and 25,000
for each month from April 1997 through January 1998.
/s/ Earl Gallegos May 8, 1998
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**Signature of Reporting Person Date
Earl Gallegos
** 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.
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.
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SEC 1473 (7-96)
