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OMB APPROVAL
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OMB Number: 3235-0104
Expires: December 31, 2001
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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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1. Name and Address of Reporting Person*
Norris Robert K.
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(Last) (First) (Middle)
7700 N.W. 37th Avenue
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(Street)
Miami FL 33147
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
November 22, 1999
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
PrintOnTheNet.com, Inc. ("POTN")
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5. Relationship of Reporting Person to Issuer
(Check all applicable)
[ ] Director [ ] 10% Owner
[ X ] Officer (give title below) [ ] Other (specify below)
Chief Financial Officer
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6. If Amendment, Date of Original (Month/Year)
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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 Beneficially Owned
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<TABLE>
<CAPTION>
3. Ownership Form:
2. Amount of Securities Direct (D) or
1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr.5)
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<S> <C> <C> <C>
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</TABLE>
* If the Form is filed by more than one Reporting Person, see Instruction
5(b)(v)
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Page 1 of 2
<PAGE>
FORM 3 (continued)
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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<TABLE>
<CAPTION>
5. Owner-
3. Title and Amount of Securities ship
Underlying Derivative Security Form of
2. Date Exercisable (Instr. 4) Derivative
and Expiration Date --------------------------------- 4. Conver- Security:
(Month/Day/Year) Amount sion or Direct 6. Nature of
---------------------- or Exercise (D) or Indirect
Date Expira- Number Price of Indirect Beneficial
1. Title of Derivative Exer- tion of Derivative (I) Ownership
Security (Instr. 4) cisable Date Title Shares Security (Instr.5) (Instr. 5)
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<S> <C> <C> <C> <C> <C> <C> <C>
Option (right to buy) (1) 11/21/09 Common Stock 125,000 $.875 D
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</TABLE>
Explanation of Responses:
(1) Options become exercisable on each of the following dates: 31,250 on
11/22/00, 31,250 on 11/22/01, 31,250 on 11/22/02 and 31,250 on 11/22/03.
/s/ Robert K. Norris 12/1/99
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**Signature of Reporting Person Date
ROBERT K. NORRIS
** 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.
Alternatively, this form is permitted to be submitted to the
Commission in electronic format at the option of the reporting person
pursuant to Rule 101(b)(4) of Regulation S-T.
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