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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5 OMB APPROVAL
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[_] Check this box if no longer OMB NUMBER: 3235-0362
subject to Section 16. Form 4 Expires: September 30, 1998
or Form 5 obligations may Estimated average burden
continue. SEE Instruction 1(b). hours per response ...... 1.0
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[_] Form 3 Holdings Reported
[_] Form 4 Transaction Reported
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
Mitcham Jana
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(Last) (First) (Middle)
10618 Great Plains
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(Street)
Houston TX 77064
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(City) (State) (Zip)
Nutrition For Life International, Inc.
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2. Issuer Name and Ticker or Trading Symbol
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3. IRS or Social Security Number of Reporting Person (Voluntary)
Septemeber 1998
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4. Statement for Month/Year
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5. If Amendment, Date of Original (Month/Day/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
X Director 10% Owner
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X Officer (give Other (Specify
----- title below) ------ below)
Executive Vice President and Secretary
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7. Individual or Joint/Group Reporting
(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 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security 2. Trans- 3. Trans- 4. Secuirties Acquired (A) 5. Amount of 6. Ownership 7. Nature
(Instr. 3) action action or Disposed of (D) Securities Form: of Indirect
Date Code Beneficially Direct Beneficial
(Instr. 8) (Instr. 3,4 and 5) Owned at End (D) or Ownership
(Month/ -------------------------- Of Issuer's Indirect (Instr. 4)
Day/ Amount (A) or Price Fiscal Year (I)
Year) (D) (Instr. 3 and 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Responses)
(Over)
SEC 2270 (3/91)
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FORM 5 (continued)
<TABLE>
<CAPTION>
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security 2. Conversion 3. Transaction 4. Transacation 5. Number of Derivative 6. Date Exercisable
(Instr. 3) or Exercise Date Code Securities Acquired (A) and Expiration
Price of (Month Day (Instr. 8) or Disposed of (D) Date
Derivative Year) (Instr. 3, 4, and 5) (Month, Day
Security Year)
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(A) (D) Date Expiration
Exer- Date
cisable
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
Right to Buy $ 5.13 03/23/98 A 20,000 09/23/98 03/22/01
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</TABLE>
<TABLE>
<CAPTION>
7. Title and Amount of 8. Price of Derivative 9. Number of Derivative 10. Ownership of 11. Nature of the
Underlying Securities Security (Instr. 5) Securities Beneficially Derivate Securitiy: Indirect Beneficial
(Instr. 3 AND 4) Owned at End of Year Direct (D) or Ownership (Instr. 4)
Instr. 4) Indirect (I) (Instr. 4)
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Title Amount or
Number of
Shares
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<S> <C> <C> <C> <C>
Common Stock 20,000 133,400 D
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8,400 I By Husband
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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/ Jana Mitcham November 16, 1998
_______________________________ _________________
**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.
Page 2
SEC 2270 (3/91)
