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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13D
Under the Securities Exchange Act of 1934
(Amendment No. 4)*
AMERICAN CLAIMS EVALUATION, INC.
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(Name of Issuer)
Common Shares, $.01 par value
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(Title of Class of Securities)
025144 10 6
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(CUSIP Number)
Mr. Gary Gelman, One Jericho Plaza, Jericho, NY (516) 938-8000
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(Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications)
July 8, 1997
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(Date of Event which Requires Filing of this Statement)
If the filing person has previously filed a statement on Schedule 13G to report
the acquisition which is the subject of this Schedule 13D, and is filing this
statement because of Rule 13d-1(b)(3) or (4), check the following box / /.
Check the following box if a fee is being paid with the statement / /. (A fee
is not required only if the reporting person: (1) has a previous statement on
file reporting beneficial ownership of more than five percent of the class of
securities described in Item 1; and (2) has filed no amendment subsequent
thereto reporting beneficial ownership of five percent or less of such class.)
(See Rule 13d-7.)
Note: Six copies of this statement, including all exhibits, should be filed with
the Commission. See Rule 13d-l(a) for other parties to whom copies are to be
sent.
*The remainder of this cover page shall be filled out for a reporting person's
initial filing on this form with respect to the subject class of securities, and
for any subsequent amendment containing information which would alter
disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
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CUSIP No. 025144 10 6 SCHEDULE 13D Page 2 of 5 Pages
1. Name of Reporting Person
S.S. or I.R.S. Identification No. of Above Person
Gary Gelman
Soc. Sec. # ###-##-####
2. Check the Appropriate Box if a Member of a Group (a) / /
(b) / /
3. SEC Use Only
4. Source of Funds*
Personal Funds
5. Check Box if Disclosure of Legal Proceedings is Required
Pursuant to Items 2(d) or 2(e) / /
6. Citizenship or Place of Organization
USA
7. Sole Voting Power
2,286,000
Number of Shares
8. Shared Voting Power
Beneficially
0
Owned by Each
9. Sole Dispositive Power
Reporting Person
2,286,000
With
10. Shared Dispositive Power
0
11. Aggregate Amount Beneficially Owned by Each Reporting Person
2,286,000
12. Check Box if the Aggregate Amount in Row (11)
Excludes Certain Shares* /X/
Excludes 10,000 shares owned by wife
13. Percent of Class Represented by Amount in Row (11)
53.5%
14. Type of Reporting Person*
IN
*SEE INSTRUCTIONS BEFORE FILLING OUT!
INCLUDE BOTH SIDES OF THE COVER PAGE, RESPONSES TO ITEMS 1-7
(INCLUDING EXHIBITS) OF THE SCHEDULE, AND THE SIGNATURE ATTESTATION.
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Page 3 of 5
Item 1. Security and Issuer
The undersigned hereby amends the statement on Schedule 13D
dated August 19, 1988 as amended by Amendment No. 1 dated July 17, 1989,
Amendment No. 2 dated November 1, 1991 and Amendment No. 3 dated July 26, 1993
(collectively called the "Schedule 13D") with respect to the common shares, par
value $.01 per share (the "Shares"), of American Claims Evaluation, Inc., a New
York corporation (the "Company"). The reporting person, on or about July 8,
1997, purchased from the Company 200,000 shares at a price of $1.25 per share,
and made payment to the Company of the $250,000 purchase price by his check
drawn to the order of the Company. He was also granted options to acquire
300,000 shares at a price of $1.25 per share under the Company's 1997 Stock
Option Plan, approved by the Board of Directors, which plan and option grant is
subject to ratification and approval by shareholders of the Company at its
forthcoming Annual Meeting of Shareholders, until such ratification is so
approved, the 300,000 shares are not reflected in the ownership of the
undersigned reported herein.
Item 2. Identity and Background
This statement is being filed by Mr. Gelman, a United States
citizen whose business address is c/o the Company, 375 North Broadway, Jericho,
New York 11753. Mr. Gelman's principal occupation is as Chairman of the Board,
President, Chief Executive and Chief Operating Officer of the Company, whose
principal business has been the verification of medical bills presented for
payment to insurance companies and others, and vocational rehabilitation
services.
Mr. Gelman has not, during the last five years, been convicted
in a criminal proceeding (excluding traffic violations or similar misdemeanors)
or been a party to a civil proceeding of a judicial or administrative body of
competent jurisdiction as a result of which he was or is subject to a judgment,
decree or final order enjoining future violations of, or prohibiting or
mandating activities subject to, federal or state securities laws or finding any
violation with respect to such laws.
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Page 4 of 5
Item 3. Source and Amount of Funds or Other Consideration
Not applicable.
Item 4. Purpose of Transaction
Not applicable.
Item 5. Interest in Securities of the Issuer
(a) The aggregate number of the Company's Shares
beneficially owned by the undersigned on the close of
business on the date set forth on the cover was
2,286,000, (approximately 53.5% of the 4,273,500
Shares outstanding on that date), based upon the
Shares reported by the Company to be issued and
outstanding.
(b) Number of Shares as to which, on the date referred to
on the cover the undersigned had:
(i) sole power to vote or to
direct the vote................... 2,286,000
(ii) shared power to vote or
to direct the vote................ 0
(iii) sole power to dispose or
to direct the disposition of ..... 2,286,000
(iv) shared power to dispose or to
direct the disposition of ........ 0
(c) Other than as described herein, there were no
transactions in the Company's Shares effected by the
undersigned during the sixty day period preceding the
date set forth on the cover.
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Page 5 of 5
After reasonable inquiry and to the best of my knowledge and
belief, I certify that the information set forth in this Schedule is true,
complete and correct.
Dated: July 14, 1997
/s/ Gary Gelman
Gary Gelman
