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UNITED STATES 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 /*/
Kashenberg Richard S.
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(Last) (First) (Middle)
5350 Mountain Springs Ranch Road
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(Street)
La Verne California 91750
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Nutrition For Life International, Inc. (NFLI)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
September 1998
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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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Officer (give Other (Specify
----- title below) ------ below)
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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>
(Print or Type Responses)
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FORM 5 (continued)
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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 $7.00 12/1/97 A 5,000 12/1/97 11/30/02
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<TABLE>
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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 5,000 21,000 D
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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/ Richard S. Kashenberg 11/16/98
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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 insufficient, See Instruction 6 for procedure.
