FORM 3
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section 16(a) of the Securities
Exchange Act of 1934
1. Name and Address of Reporting Person:
San Filippo James
(Last) (First) (Middle)
195 Carter Drive Edison NJ 08817
(Street) (City) (State) (Zip)
2. Date of Event Requiring Statement:
10/21/99
(Month/Day/Year)
3. IRS or Social Security Number of Reporting Person (Voluntary):
4. Issuer Name and Ticker or Trading Symbol:
Pentech International Inc./PNTK
5. Relationship of Reporting Person to Issuer (Check all
applicable):
Director
10% Owner
X Officer (give title below)
Other (Specify below)
Vice President-Finance
6. If Amendment, Date of Original:
(Month/Day/Year)
Table I - Non-Derivative Securities Beneficially Owned:
1. Title of Security:
Common Stock
2. Amount of Securities Beneficially Owned:
29,214*
3. Ownership Form-Direct (D) or Indirect (I):
D
4. Nature of Indirect Beneficial Ownership:
Table II - Derivative Securities Beneficially Owned (e.g., puts,
calls, warrants, options, convertible securities):
1. Title of Derivative Security:
Common Stock
Common Stock
Common Stock
2. Date Exercisable and Expiration Date (Month/Day/Year):
8/5/99 8/5/03
3/3/00 3/3/03
3/19/98 3/19/02
(Date Exercisable) (Expiration Date)
3. Title and Amount of Securities Underlying Derivative Security:
Common Stock 10,000
Common Stock 10,000
Common Stock 5,000
(Title) (Amount of Number of Shares)
4. Conversion or Exercise Price of Derivative Security:
$1.50
$.875
$1.4375
5. Ownership Form of Derivative Security: Direct (D) or Indirect
(I):
D
D
D
6. Nature of Indirect Beneficial Ownership:
Explanation of Responses:
* Includes options to purchase 25,000 shares of Common Stock
of Pentech International Inc. ("Common Shares") whether or
not presently exercisable. Also includes 4,214 Common
Shares held in Mr. San Filippo's 401(K) Plan which is 60%
vested.
s/James San Filippo 1/4/00
Signature of Reporting Person Date
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