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OMB APPROVAL
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- ------ OMB Number: 3235-0362
FORM 5 Expires: September 30, 1997
- ------ 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 to
Grosser Robert Cityscape Financial Corp. (CTYS) Issuer (Check all applicable)
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- ---
Number of Reporting Month/Year Officer (give Other (Specify
565 Taxter Road Person (Voluntary) December 1997 ---- title --- below)
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(Street) 5. If Amendment, ------------------------
Date of Original 7. Individual of Joint/Group Reporting
(Month/Year) (check applicable line)
/x/ Form Filed by one Reporting Person
/ / Form Filed by More than One
Elmsford New York 10523 Reporting Person
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(City) (State) (Zip) 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 5/22/97 G 30,000 D D
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3,758,444 D
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800(1) I By daughter
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800(1) I By daughter
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640(2) I By spouse
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800(3) I By daughter
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800(3) I By daughter
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(Print or Type Responses) SEC 2270 (3/91)
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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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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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Employee Stock Option $13.25 4/22/97 4/22/07 Common 25,000
(right to buy) Stock
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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 (l) (Instr. 4)
of Year (Instr. 4)
(Instr. 4)
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Employee Stock Option 25,000 D
(right to buy)
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Explanation of Responses:
(1) Held in trust for daughter who shares reporting person's household,
reporting person's spouse as trustee.
(2) 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.
(3) Reporting person as custodian for daughter who shares reporting person's
household.
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**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Robert Grosser 2/6/98
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. SEC 2270 (3/91)
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