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OMB Number 3235-0287
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
/ / Check this box if no longer subject to Section 16.
Form 4 or Form 5 obligations may continue. See
Instruction 1(b).
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 (If the form is filed
by more than one reporting person, see Instruction 4(b)(v).)
Jacquet Richard J.
(Last) (First) (Middle)
500 Broadway
(Street)
Redwood City CA 94063
(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Ampex Corporation (AXC)
3. IRS or Social Security Number of Reporting Person
(Voluntary)
4. Statement for
(Month/Year)
11/97
<PAGE>
5. If Amendment, Date of Original
(Month/Year)
11/97
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify
below)
Vice President
7. Individual or Joint/Group filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
<PAGE>
<TABLE>
TABLE I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
<S> <C> <C> <C> <C> <C> <C>
1. Title of 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership 7. Nature of
Security action action or Disposed of (D) Securities Form: Indirect
(Instr.3) Date Code (Instr.3, 4 and 5) Beneficial Direct (D) Beneficial
(Month (Instr.8) ly Owned or Ownership
/Day/Year) at End of Indirect
Month (I) (Instr. 4)
(Inst. 3 (Instr. 4)
and 4)
------------------------------------------------------------------------------------------
Code V Amount (A) or Price
(D)
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------
- ------------------------------------------------------------------------------------------------------------------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4(b)
(v).
<PAGE>
<TABLE>
TABLE II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
<S> <C> <C> <C> <C> <C>
1. Title of 2. Conver- 3. Trans- 4. Transaction 5. Number of Deriv- 6. Date Exercisable and
Derivative sion or action Code ative Securities Expiration Date
Security Exercise Date Acquired (A) or (Month/Day/Year)
(Instr.3) Price of (Instr. 8) Disposed of (D)
Deri- (Month/
vative Day/ (Instr. 3, 4,
Security Year) and 5)
-------------------------------------------------------------------------------------
Code V (A) (D) Date Exer- Expiration
cisable Date
- ----------------------------------------------------------------------------------------------------------------------------------
Option to acquire $3.125 11/19/97 A V 12,500 (Note 1) (Note 1)
(Note 1)
- ----------------------------------------------------------------------------------------------------------------------------------
Option to acquire $3.125 11/19/97 A V 17,500 (Note 3) (Note 3)
(Note 3)
- ----------------------------------------------------------------------------------------------------------------------------------
Option to acquire $5.75 11/19/97 D V 12,500 (Note 4) (Note 4)
(Note 4)
- ----------------------------------------------------------------------------------------------------------------------------------
Option to acquire $10.50 11/19/97 D V 10,000 (Note 5) (Note 5)
(Note 5)
- ----------------------------------------------------------------------------------------------------------------------------------
Option to acquire $4.875 11/19/97 D V 7,500 (Note 6) (Note 6)
(Note 6)
- ----------------------------------------------------------------------------------------------------------------------------------
</TABLE>
<TABLE>
<S> <C> <C> <C> <C> <C>
1. Title of 7. Title and Amount of 8. Price of 9. Number of 10. Ownership 11. Nature of
Derivative Underlying Securities Derivative Derivative Form of Deriva- Indirect Bene-
Security Security Securities tive Security: ficial Owner-
(Instr.3) (Instr.3 and 4) Beneficially Direct (D) or ship (Instr.
(Instr. 5) Owned at End Indirect (I) 4)
of Month (Instr. 4)
------------------------
Title Amount or (Instr. 4)
Number of
Shares
- -----------------------------------------------------------------------------------------------------------------------
Class A Common Stock 12,500 $0 (Note 2) D
- -----------------------------------------------------------------------------------------------------------------------
Class A Common Stock 17,500 $0 (Note 2) D
- -----------------------------------------------------------------------------------------------------------------------
Class A Common Stock 12,500 $0 (Note 2) D
- -----------------------------------------------------------------------------------------------------------------------
Class A Common Stock 10,000 $0 (Note 2) D
- -----------------------------------------------------------------------------------------------------------------------
Class A Common Stock 7,500 $0 (Note 2) D
- -----------------------------------------------------------------------------------------------------------------------
</TABLE>
Explanation of Responses:
Note 1: Non-qualified stock option grant pursuant to Rule 16b-3 under the Ampex
Corporation Stock Incentive Plan (the "Plan"). The option becomes exercisable
on October 28, 2002, subject to accelerated vesting as approved by the Stock
Incentive Plan Committee in accordance with the Plan, and expires 15 months
after the applicable vesting date.
Note 2: The column 9 total does not include other options outstanding under the
Plan, because their exercise prices and exercise periods are different.
Note 3: Non-qualified stock option grant pursuant to Rule 16b-3 under the Plan.
This option becomes exercisable as to 34% of the underlying shares on October
28, 1998, and as to the balance at the rate of 8.25% quarterly thereafter until
October 28, 2000. The option will expire as to equivalent percentages of
underlying shares 15 months after the applicable vesting date for such shares.
Note 4: Cancellation of non-qualified stock option originally granted on July
16, 1996 pursuant to Rule 16b-3 under the Plan. This option would have become
exercisable on July 16, 2001, subject to accelerated vesting, and would have
expired 15 months after the applicable vesting date.
Note 5: Cancellation of non-qualified stock option originally granted on
December 13, 1996 pursuant to Rule 16b-3 under the Plan. This option would have
become exercisable as to 34% of the underlying shares on December 13, 1997 and
as to the balance at the rate of 8.25% quarterly thereafter until Decmeber 13,
1999, and would have expired as to equivalent percentages of underlying shares
15 months after the applicable vesting dates for such shares.
Note 6: Cancellation of non-qualified stock option originally granted on
July 18, 1997 pursuant to Rule 16b-3 under the Plan. This option would have
become exercisable as to 34% of the underlying shares on July 18, 1998 and as to
the balance at the rate of 8.25% quarterly thereafter until July 18, 2000, and
would have expired as to equivalent percentages of underlying shares 15 months
after the applicable vesting dates for such shares.
/s/Richard J. Jacquet 12/5/97
- -------------------------------- ------------------
**Signature of Reporting Person Date
Richard J. Jacquet
** 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 is sufficient, 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.
