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OMB APPROVAL
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- ------ OMB Number: 3235-0362
FORM 5 Expires: September 30, 1998
- ------ Estimated average burden
hours per response .... 1.0
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/ / Check box if no U.S. SECURITIES AND EXCHANGE COMMISSION
longer subject to WASHINGTON, DC 20549
Section 16. Form
4 or Form 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
obligations may
continue. See Filed pursuant to Section 16(a) of the Securities
Instruction 1(b) Exchange Act of 1934,
/ / Form 3 Holdings Section 17(a) of the Public Utility
Reported Holding Company Act of 1935 or Section 30(f) of
/ / Form 4 the Investment Company Act
Transactions of 1940
Reported
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<S> <C> <C> <C> <C> <C> <C>
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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)
GROSSER ROBERT CITYSCAPE FINANCIAL CORP. (CTYS) " to Issuer (Check all applicable)
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year X Officer (give Other (Specify
39 WINDGATE DRIVE Person (Voluntary) December 31, 1996 ---- title --- below)
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(Street) 5. If Amendment, CHAIRMAN OF THE BOARD,
Date of Original CEO & PRESIDENT
(Month/Year) -----------------------------------
NEW CITY NEW YORK 10956
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(City) (State) (Zip) 7. Individual or Joint/Group Reporting
(check applicable box)
X Form Filed by One Reporting Person
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Form Filed by More Than One
--- Reporting Person
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TABLE 1 -- 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 Issuer's Direct Benefi-
(Month/ Fiscal Year (D) or cial
Day/ ---------------------------- (Instr. 3 and 4) Indirect Owner-
Year) Amount (A) or Price (I) ship
(D) (Instr. 4) (Instr.
4)
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COMMON STOCK 12/23/96 G 640 A 640(1) I BY SPOUSE
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COMMON STOCK 5,268,444 D
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COMMON STOCK 800(2) I BY DAUGHTER
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COMMON STOCK 800(2) I BY DAUGHTER
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Reminder: Report on a seperate line for each class of securities beneficially owned directly or indirectly. (Over)
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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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<S> <C> <C> <C> <C> <C> <C> <C>
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
(A) (D) cisable Date Shares
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SHORT CALL OPTION $1.25 7/1/96 3/10/00 COMMON STOCK 1,380,000
(obligation to sell)
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<S> <C> <C> <C>
1. Title of Derivative 9. Number of 10. Ownership 11. Nature of
Security Derivative of Derivative Indirect
(Instr. 3) Securities Security: Beneficial
Beneficially Direct (D) Ownership
Owned at End or Indirect (I) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
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SHORT CALL OPTION 1,380,000 D
(obligation to sell)
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Explanation of Responses:
(1) THE REPORTING PERSON DISCLAIMS BENEFICIAL OWNERSHIP OF THESE SECURITIES, AND THIS REPORT SHALL NOT BE DEEMED AN ADMISSION
THAT THE REPORTING PERSON IS THE BENEFICIAL OWNER OF SUCH SECURITIES FOR PURPOSES OF SECTION 16 OR FOR ANY OTHER PURPOSE.
(2) REPORTING PERSON AS CUSTODIAN FOR DAUGHTER WHO SHARES REPORTING PERSON'S HOUSEHOLD.
/s/ Robert Grosser 2-13-97
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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.
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.
Page 2
SEC 2270 (7-96)
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