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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 3 OMB APPROVAL
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OMB NUMBER: 3235-0104
Expires: September 30, 1998
Estimated average burden
hours per response ...... 0.5
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INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
Filed pursuant to Section16(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
(Print or Type Responses)
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1. Name and Address of Reporting Person
Boxall Alexander Peter
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(Last) (First) (Middle)
c/o Advanced Deposition Technologies, Inc.
580 Myles Standish Blvd.
Myles Standish Industrial Park
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(Street)
Taunton Massachusetts 02780
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
December 20, 1997
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Issuer Name and Ticker or Trading Symbol
Advanced Deposition Technologies, Inc. (ADTC)
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5. Relationship of Reporting Persons to Issuer:
(Check all applicable)
X Director 10% Owner
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Officer (give Other (Specify
----- title below) ------ below)
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6. If Amendment, Date of Original (Month/Day/Year)
N/A
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7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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Form filed by More than One Reporting Person
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<TABLE>
<CAPTION>
Table I -- Non-Derivative Securities Beneficially Owned
1. Title of Security 2. Amount of Securities 3. Ownership Form: 4. Nature of Indirect Beneficial Ownership
(Instr. 4) Beneficially Owned Direct (D) or (Instr. 5)
(Instr. 4) Indirect (I)
(Instr. 5)
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<S> <C> <C> <C>
Common Stock 280,000 D
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</TABLE>
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FORM 3 (continued)
<TABLE>
<CAPTION>
Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of
(Instr. 4) cisable and Underlying Derivative Security or Exercise Form of Indirect
Expiration (Instr. 4) Price of Derivative Beneficial
Date Derivative Security: Ownership
(Month/Day/ Security Direct (D) (Instr. 5)
Year) or
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Date Expira- Amount (Instr. 5)
Exer- tion or
cisable Date Title Number
of
Shares
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<S> <C> <C> <C> <C> <C> <C> <C>
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</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/ Alexander Peter Boxall December 30, 1997
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**Alexander Peter Boxall (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.
