Annual Statement/Changes In Beneficial Ownership
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 box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b)
[ X] Form 3 Holdings Reported
[ X] Form 4 Transactions Reported
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1. Name and Address of Reporting Person*
CALK STEPHEN
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(Last) (First) (Middle)
401 NORTH MICHIGAN AVENUE
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(Street)
CHICAGO, IL 60611
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
NUCLEUS, INC. (NCLS)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
DECEMBER 31, 1999
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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)
[ X ] Director [ ] 10% Owner
[ ] Officer (give title below) [ ] Other (specify below)
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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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<TABLE>
<CAPTION>
5.
4. Amount of
Securities Acquired Securities 7.
2. (A) or Disposed of (D) Beneficially 6. Nature of
Transaction 3. (Instr. 3, 4 and 5) Owned at End Ownership Form: Indirect
1. Date Transaction --------------------- of Issuer's Direct (D) Beneficial
Title of Security (Month/Day/ Code Amount (A)or Price Fiscal Year or Indirect (I) Ownership
(Instr. 3) Year) (Instr. 8) (D) (Instr. 3 and 4) (Instr.4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
COMMON STOCK 4/15/99 P4 106,140 A 0.9422 172,807 D
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COMMON STOCK 5/13/99 P4 66,667 A $1.50
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
<PAGE>
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>
5. 6. 7.
Number of Date Title and
Derivative Excercisable Amount of
Securities and Underlying 9. 10.
Acquired Expiration Securities Number of Ownership
(A) or Date (Instr. 3 Derivative of 11.
1. 2. 3. Disposed (Month/ and 4) 8. Securities Derivative Nature
Title of Conversion Trans- 4. of (D) Day/Year) ------------ Price of Beneficially Security: of
Deriva- or Exercise action Trans- (Instr. 3, -------------- Amount Deriva- Owned Direct Indirect
tive Price of Date action 4 and 5) Date Expir- or tive at End (D) or Beneficial
Security Derivative (Month/ Code -------- Exer- ation Number of Security of Year Indirect (I) Ownership
(Instr.3) Security (Day/Year) (Inst. 8) (A) (D) cisable Date Title Shares (Instr.5) (Instr.4) (Instr.4) (Instr.4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C> <C>
DIRECTOR $1.50 4/15/99 A 120,000 <F1> 4/15/09 Common 120,000 120,000 D
STOCK Stock
OPTIONS*
(RIGHT
TO BUY)
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</TABLE>
Explanation of Responses:
<F1>
60,000 options vested immediately and the remaining 60,000 options vest in three
equal annual installments beginning April 15, 2000.
/s/ STEPHEN CALK 5/24/00
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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.
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