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Previous: MUNICIPAL INVT TR FD INTERM TERM SER 226 DEFINED ASSET FDS, 497, 1999-05-21 |
Next: LIFEPOINT INC, 3, 1999-05-21 |
FORM 4
U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may
continue. See Instruction 1(b)
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 of Section 30(f) of the
Investment Company Act of 1940
<TABLE>
<CAPTION>
- ------------------------------------------------------------------ -----------------------------------------------------------------
Name and Address of Reporting Person 2. Issuer Name and Ticker or Trading Symbol
LifePoint, Inc. -- LFPT
Gold Peter S.
(Last) (First) (Middle)
5 Beverly Park
- -----------------------
(Street)
Beverly Hills CA 90210
(City) (State) (Zip)
- ------------------------------------------------------------------ -----------------------------------------------------------------
- ------------------------------------------------------------------ ------------------------- ---------------------------------------
3. IRS or Social 4. Statement for Month/Year
Security Number of 4/99
Reporting Person
(Voluntary)
###-##-####
- ------------------------------------------------------------------ ------------------------- ---------------------------------------
- ------------------------------------------------------------------ ------------------------- ---------------------------------------
5. If Amendment, Date of Original
(Month/Year)
- ------------------------------------------------------------------ ------------------------- ---------------------------------------
- --- ----------------------------------------------
6. Relationship of Reporting Person to
Issuer
(Check if Applicable)
_x__ Director ___ 10% Owner
__ Officer (give ___ Other (specify
title below)
below)
- --------------------------------- --------------------------------------------------------------------------------------------------
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
- --------------------------------- ------------------------------------------------------------------------
- --------------------------------- ------------------- ------------------ --------------------------------
1. Title of Security 2. Transaction 3. Transaction 4. Securities Acquired (A) or
(Instr. 3) Date Code Disposed of (D) (Instr. 3, 4,
(Month/Day/Year) (Instr. 8) and 5)
- --------------------------------- ------------------- ------------------ --------------------------------
- --------------------------------- ------------------- ---------- ------- ----------- --------- ----------
<S> <C> <C> <C> <C> <C>
Code V Amount (A) or Price
(D)
- --------------------------------- ------------------- ---------- ------- ----------- --------- ----------
- --------------------------------- ------------------- ---------- ------- ----------- --------- ----------
Common Stock, $.001 par value N/A N/A 100,000 N/A N/A
- --------------------------------- ------------------- ---------- ------- ----------- --------- ----------
Common Stock, $.001 par value N/A N/A 600,000 N/A N/A
- --------------------------------- ------------------- ---------- ------- ----------- --------- ----------
- --------------- ----------- ---------------
<C> <C> <C>
5. Amount of 6. 7. Nature of
Securities Owner-ship Indirect
Beneficially Form: Beneficially
Owned at End Direct Ownership
of Month (D) or (Instr. 4)
(Instr. 3 and Indirect
4) (I)
(Instr. 4)
- --------------- ----------- ---------------
100,000 D N/A
- --------------- ----------- ---------------
600,000 I Trustee and
co-beneficiary
of revocable
Intervivos Trust
- --------------- ----------- ---------------
- --------------- ----------- ---------------
</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
<PAGE>
Form 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or
Beneficially Owned(e.g., puts, calls, warrants, options, convertible securities)
<TABLE>
<CAPTION>
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
1. Title of Derivative 2. 3. 4. 5.Number of 6. Date 7. Title and Amount of
Security (Instr. 3) Conversion Transaction Transaction Derivation Exercisable Underlying Securities
or Date Code (Instr.8) Securities and Expiration (Instr. 3 and 4)
Exercisable (Month/Day/ Acquired (A) Date
Price Year) or Disposed (Month/Date/Year)
of of (D)
Derivative (Instr. 3,4,
Security and 5)
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
- ---------------------------- ------------- ------------- ------- ------- -------- ------ -------- ------- ------------ ------------
Code V (A) (D) Date Expira Title Amount or
Exerci tion Number of
sable Date Shares
- ---------------------------- ------------- ------------- ------- ------- -------- ------ -------- ------- ------------ ------------
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
<S> <C> <C> <C> <C> <C> <C> <C>
Common Stock Options $1.81 4/16/99 A 15,000 0 (1) 4/15/09 Common 15,000
Stock
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
Common Stock Purchase N/A N/A N/A 100,000 0 N/A N/A N/A 100,000
Warrant
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
Common Stock Purchase N/A N/A N/A 100,000 0 N/A N/A N/A 100,000
Warrant
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
- ---------------------------- ------------- ------------- --------------- --------------- ---------------- -------------------------
- ------------- ------------- ----------- -----------
<C> <C> <C> <C>
8. Price of 9. Number 10. 11.
Derivative of Ownership Nature of
Security Derivative Form of Indirect
(Instr. 5) Securities Derivative Beneficial
Beneficially Security: Ownership
Owned at Direct (Instr. 4)
end of (D) or
month Indirect
(Instr. 4) (I)
(Instr. 4)
- ------------- ------------- ----------- -----------
- ------------- ------------- ----------- -----------
0 15,000 D N/A
- ------------- ------------- ----------- -----------
N/A 115,000 D N/A
- ------------- ------------- ----------- -----------
N/A 215,000 D N/A
- ------------- ------------- ----------- -----------
- ------------- ------------- ----------- -----------
</TABLE>
Explanation of Responses: (1) Becomes exercisable as to 3,750 shares on
4/16/00 becomes exercisable as to 321 shares on the 30th day of each month for
35 months thereafter and become exercisable as to 15 shares on the 30th day of
the 36th month thereafter.
By: /s/ Peter S. Gold
Signature of Reporting Person
Date: 5/17/99
**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.
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