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Previous: TOP SOURCE TECHNOLOGIES INC, 5, 1997-11-07 |
Next: PREMARK INTERNATIONAL INC, 10-Q, 1997-11-07 |
<TABLE>
<CAPTION>
- ---------------- U.S. SECURITIES AND EXCHANGED COMMISION ----------------------------
|F O R M 5| Washington, D.C. 20549 | OMB APPROVAL |
- ---------------- |--------------------------|
Check this box if ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0362|
[ ] no longer Subject |Expires: September 30,1998|
to Section 16. |Estimated ave. burden |
|hours per response.....1.0|
[ ] Form 3 Holdings Rep. Filed pursuant to Section 16(a) of the Securities Exchanged Act of 1934, ----------------------------
Section 17(a) of the Public Utility Holding Company Act of 1935 or
[ ] Form 4 Trans. Rep. Section 30(f) of the Investment Company Act 1940
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Name and Address of Reporting Person* |2.Issuer Name and Ticker or Trading Symbol |6.Relationship of Reporting Person to |
| | | Issuer (Check all Applicable) |
|Sadeghi Mani A |TOP SOURCE TECHNOLOGIES, INC. (TPS ) | |
| | | X Director 10% Owner |
|----------------------------------------|------------------------------------------------|--- --- |
| (Last) (First) (MI)|3.IRS or Soc. Sec. No. |4.Statement for Month/ | Officer Other |
| | of Reporting Person | Year |---(give title below) ---(Specify below)|
| 35 Manor Drive | (Voluntary) | | |
| | | 10/01/1996 | |
| | | | |
|----------------------------------------| |------------------------|----------------------------------------|
| (Street) | |5.If Amendment, Date of |7. Individual or Joint/Group Filing |
| | ###-##-#### | Original (Month/Year) | (Check Applicable Line) |
| | | | |
|Morristown NJ 07960 | | | X Form filed by One Reporting Person |
| | | |--- |
| | | | Form filed by More than One |
| | | |--- Reporting Person |
|----------------------------------------------------------------------------------------------------------------------------------|
| (City) (State) (Zip) |
| TABLE I - Non-Derivative Securities Acquired, Disposed of or Beneficially Owned |
|----------------------------------------------------------------------------------------------------------------------------------|
|1.Title of Security |2.Transac- |3.Trans. |4.Security Acquired (A) or |5.Amount of |6. |7.Nature of Indirect|
| (Instr. 3) | tion Date | Code | Disposed of (D) | Securities |Own.| Beneficial |
| |(Mon/Day/Yr)|(Instr.8)| (Instr. 3, 4 & 5) | Beneficially |Form| Ownership |
| | | | | Owned at End of|(D) | (Instr. 4) |
| | | |-------------------------------| Issuer's |or | |
| | | | |(A) | | Fiscal Year |(I) | |
| | | | Amount |(D) | Price | (Instr. 3 & 4) | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |
|Common Stock | | | | | $.0000| 20000 | D | |
| | | | | | | | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
| | | | | | | | | |
| | | | | | | | | |
|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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|-------------------------------|------------|---------|----------------|----|---------|-----------------|----|--------------------|
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- ------------------------------------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class securities owned directly or indirectly. SEC 2270 (7-96)
*If the form is filed by more than one reporting person, see Instruction 4(b)(v).
PAGE: 1 OF 2
</TABLE>
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<TABLE>
<CAPTION>
FORM 5 (continued) TABLE II - Derivative Securities Acquired, Disposed of, Beneficially Owned
(e.g., puts, calls, warrants, options, convertible security)
- ------------------------------------------------------------------------------------------------------------------------------------
|1.Title of|2.Conver-|3. |4.Tran- |5.Number of |6.Date |7.Title and Amount |8.Price of|9.Number |10. |11.Nature |
|Derivative|sion or |Trans| saction| Derivative |Exercisable| of Underlying |Derivative| of |Own.| of |
|Security |Exercise |Date | Code | Securities |and | Securities |Security |Derivative|Form|Indirect |
|(Instr. 3)|Price of |(Mon/|(Instr.8)| Acquired (A) or |Expiration | (Instr. 3 & 4) |(Instr. 5)|Securities|of |Beneficial|
| |Deriva- | Day/| | Disposed of (D) |Date | | |Benefi- |Deri|Ownership |
| |tive |Year)| | (Instr. 3, 4 & 5) |(Month/Day/| | |cially |Sec.|(Instr. 4)|
| |Security | | | | Year) | | |Owned at |Dir.| |
| | | | | |-----------|---------------------| |End of |(D) | |
| | | | | | | | |Amount or | |Year |or | |
| | | | |---------------------|Date |Exp. | Title |Number of | |(Instr. 4)|Ind.| |
| | | | | (A) | (D) |Exbl.|Date | |Shares | | |(I) | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
|<S> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |<C> |
|Stock Opti| $1.7500|06/25| A | 7500| |12/31|06/25|Common Sto| 7500| $1.7500 | 7500| D | |
|on | | 1997| | | | 1997| 2007|ck | | | | | |
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| | | | | (01)| | | | | | | | | |
|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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|----------|---------|-----|---------|----------|----------|-----|-----|----------|----------|----------|----------|----|----------|
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- ------------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses:
(01) Grant to reporting person on 6/25/97 of non-qualified stock options to purchase 7,500 shares of common stock. The
options shall vest in six installments of 1,250 stock options each December 31st and June 30th, provided
that the reporting person is still serving as a Director of the Company on the applicable vesting date.
**Intentional misstatements or omissions of facts constitute Federal /s/Mani A. Sadeghi 11/07/1997
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.
If space provided is insufficient, see Instruction 6 for procedure. SEC 2270 (7-96)
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 OMD Number
Sadeghi, Mani TOP SOURCE TECHNOLOGIES, INC. 10/01/1996 PAGE: 2 OF 2
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