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
--------------------------------------------------------------------------
1. Name and Address of Reporting Persons
Dalia Ophir
c/o Cover-All Technologies, Inc.
18-01 Pollitt Drive
Fair Lawn, NJ 07410
---------------------------------------------------------------------------
2. Date of Event Requiring Statement
(Month/Day/Year)
01/01/98
--------------------------------------------------------------------------
3. IRS or Social Security Number of Reporting Person (Voluntary)
--------------------------------------------------------------------------
4. Issuer Name and Ticker or Trading Symbol
COVER-ALL TECHNOLOGIES, INC. (COVR)
---------------------------------------------------------------------------
5. Relationship of Reporting Person to Issuer
(Check all applicable)
Director 10% Owner
---- ----
X Officer Other (specify below)
---- (give ----
title
below)
Chief Technology Officer
-------------------------
---------------------------------------------------------------------------
6. If Amendment, Date of
Original (Month/Day/Year)
---------------------------------------------------------------------------
7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
----
Form filed by More than One Reporting Person
----
---------------------------------------------------------------------------
TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
---------------------------------------------------------------------------
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)
----------------- ------------ ---------------- ------------------
----------------- ------------ ---------------- ------------------
----------------- ------------ ---------------- ------------------
----------------- ------------ ---------------- ------------------
----------------- ------------ ---------------- ------------------
-----------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities
beneficially owned directly or indirectly. (Print or Type Responses)
* 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)
---------------------------------------------------------------------------
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)
-------------------- --------------------- --------------------------
Date Expira- Amount
Exer- tion Title or
cisable Date Number
of
Shares
---------- --------- --------- ----------
Options (rights to 7/21/95 7/20/98 Common
buy) Stock 15,000
------------------- ---------- --------- --------- ----------
Options (rights to 4/17/96 4/16/2001 Common 15,000
buy) Stock
------------------- ---------- --------- --------- ----------
Options (rights to 2/6/97 2/5/99 Common 10,000
buy) Stock
------------------- ---------- --------- --------- ----------
Options (rights to 9/1/98 1/1/2000 Common 150,000
buy) Stock
------------------- ---------- --------- --------- ----------
Options (rights to 4/6/95 4/5/98 Common 2,200
buy) Stock
------------------- ---------- --------- --------- ----------
Options (rights to 9/30/96 9/29/98 Common 20,400
buy) Stock
------------------- ---------- --------- --------- ----------
Options (rights to 4/29/97 4/29/99 Common 40,000
buy) Stock
------------------- ---------- --------- --------- ----------
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)
----------------- -------------------------- -------------
$1.75 D
----------------- -------------------------- -------------
$5.00 D
----------------- -------------------------- -------------
$1.38 D
----------------- -------------------------- -------------
$4.00 D
----------------- -------------------------- -------------
$1.75 D
----------------- -------------------------- -------------
$2.00 D
----------------- -------------------------- -------------
$2.00 D
----------------------------------------------------------------------
Explanation of Responses:
By: /s/ David E. Weiss April 29, 1999
------------------------------- -------------------
David E. Weiss, Date
Power of Attorney
* 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.
Page 2
SEC 1473 (7-96)
