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FORM 4 OMB APPROVAL
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[ ] Check this box if no OMB Number: 3235-0287
longer subject to Expires: September 30, 1998
Section 16. Form 4 Estimated average burden
or Form 5 obligations hours per response .... 0.5
may continue. See ---------------------------
Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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
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<S> <C> <C> <C> <C> <C> <C>
(Print or Type Responses)
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1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s)
Williams, Jonnie R. Eye Technology, Inc. EYTC to Issuer (Check all applicable)
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Eye Technology, Inc. Number of Reporting Month/Year X Officer (give Other (Specify
16 South Market Street Person (voluntary) 10/98 ---- title --- below)
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(Street) 5. If Amendment, Chief Operating Officer
Petersburg, Virginia 23803 Date of Original and Executive Vice
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(City) (State) (Zip) 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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1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature
(Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In-
Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct
(Instr. 8) End of Month Direct Benefi-
(Month/ (Instr. 3 and 4) (D) or cial
Day/ --------------------------------------- Indirect Owner-
Year) Code V Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr.
4)
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* 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.
(Over)
(Print or Type Responses)
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FORM 4 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
<S> <C> <C> <C> <C> <C> <C> <C>
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1. Title of Derivative 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price
Security sion or action action Derivative cisable and of Underlying of
(Instr. 3) Exercise Date Code Securities Ac- Expiration Securities Deriv-
Price of (Month/ (Instr. 8) quired (A) or Date (Instr. 3 and 4) ative
Deriv- Day/ Disposed of (D) (Month/Day/ Secur-
ative Year) (Instr. 3, 4, Year) ity
Security and 5) (Instr. 5)
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Date Expira- Amount or
-------------------------- Exer- tion Title Number of
Code V (A) (D) cisable Date Shares
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Series B Preferred Stock 3280 for 1 10/21/98 J(1) 61 (2) Common Stk. 200,080
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<C> <C> <C>
9. Number of 10. Ownership 11. Nature of
Derivative Form of Indirect
Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at End Direct (D) (Instr. 4)
of Month or Indirect (I)
(Instr. 4) (Instr. 4)
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10,369 I(3) Regent Court Technologies,
a Missouri partnership
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Explanation of Responses:
(1) Regent Court Technologies, a Missouri partnership, contributed to the capital of the Issuer 61
shares of Series B Convertible Preferred Stock.
(2) Exercisable immediately upon approval by the Issuer's stockholders of an increase in the authorized
number of shares of Common Stock.
(3) Mr. Williams is a partner in the Partnership and is the indirect beneficial owner of only 8/17 of
the derivative securities held by the Partnership
/s/ JONNIE R. WILLIAMS 11/10/98
Intentional misstatements or omissions of facts constitute Federal Criminal Violations. ------------------------------- --------
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). **Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed. Page 2
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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