Form 4 __ OMB APPROVAL
|__| Check this box if no longer OMB Number : 3235-0287
subject to Section 16. Form 4 Expires:April 30, 1997
or Form 5 obligations may Estimated average burden
continue. See Instructions 1(b). hours per response...0.5
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D. C. 20549
ANNUAL 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
1. Name and Address of Reporting Person
Allen Daniel J
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(Last) (First) (Middle)
35 Frost Road
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(Street)
Derry NH 03038
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(City) (State) (Zip)
2. Issuer Name and Ticker Or Trading Symbol
Xerographic Laser Images Corp.
3. IRS or Social Security
Number of Reporting
Person (Voluntary)
###-##-####
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4. Statement for
Month/Year
June 1997
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5. If Amendment, Date of
Original
(Month/ Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
Director 10% Owner
--- ---
X Officer (give Other (specify
--- title below) --- below)
V.P. Engineering
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<TABLE>
Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<CAPTION>
1.Title of Security 2.Transaction Date 3.Transaction Code 4.Securities Acquired (A) or
(Instr. 3) (Month/day/year) (Instr. 8) Disposed (D)
Code V (Instr. 3,4,5)
Amount (A) or (D) Price
----------------- ---------------- ----- ----- ------ --------- ------
<S> <C> <C> <C>
Common Stock June/1997 J 80,000 A $.125
Common Stock
<CAPTION>
1.Title of Security 5.Amount of Securities 6.Ownership Form: 7.Nature of Indirect
(Instr. 3) Owned at End of Direct (D) or Beneficial
Issuer's Month Indirect (I) Ownership
(Instr. 3 and 4) (Instr. 4) (Instr. 4)
----------------- -------------------- ---------------- -------------------------
<S> <C> <C>
Common Stock 80,000 D
Common Stock 65,000 D
</TABLE>
Form 4 (continued)
<TABLE>
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<CAPTION>
1.Title of Derivative 2.Conversion of 3.Transaction 4.Transaction Code 5.Number of Derivative
Security Exercise Price of Date (Instr. 8) Securities Acquired (A) or
(Instr. 3) Derivative Security (Month/Day/ Disposed (D)
Year) Code V (A) (D)
-------------------- -------------------- ------------ ------- ------- --------- ---------
<S> <C> <C> <C> <C>
Options $.125 6/3/97 J A
Options
Options $.125 6/97 J D
<CAPTION>
1.Title of Derivative 6.Date Exercisable 7.Title and Amount 8.Price of Deri- 9.Number of Derivative
Security and Expiration Date of Underlying vative Security Securities Beneficially
(Instr. 3) (Month/Day/Year) Securities (Instr. 5) Owned at End of Month
(Instr. 3 and 4) (Instr. 4)
Date Amount or
Exerci- Expiration Number of
sable Date Title Shares
-------------------- --------- ---------- ------- --------- ---------------- -----------------------
<S> <C> <C> <C> <C> <C> <C>
Options 6/3/97 6/3/02 Common 30,000 30,000
Stock
Options Common 40,001 40,001
Stock
Options Common 80,000 --
Stock
<CAPTION>
1.Title of Derivative 10.Ownership Form of 11.Nature of Indirect
Security Derivative Securi- Beneficial Owner-
(Instr. 3) ties Beneficially ship
Owned at End of (Instr. 4)
Month
(Instr. 4)
-------------------- --------------------- ------------------
<S> <C> <C>
Options D
Options D
Options
</TABLE>
Explanation of Responses:
** Intentional misstatements or omissions of facts constitute
Federal Criminal Violations.
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a)
/s/Daniel J. Allen 6/13/97
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** Signature of Reporting Person Date
Note: File three copies of this Form, one of which must be manually signed.
If space provided is insufficent, see Instructions 6 for procedure.
