U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 10-C
Report by Issuer of Securities Quoted on Nasdaq
Inter-Dealer Quotation System Filed Pursuant to
Section 13 or 15(d) of the Securities Exchange Act
of 1934 an Rules 13a-17 and 15d-17 Thereunder
BALTIC INTERNATIONAL USA, INC.
(Exact Name or Issuer as Specified in Charter)
1990 Post Oak Boulevard, Suite 1630, Houston, Texas 77056
(Address of Principal Executive Offices)
(713) 961-9299
(Issuer's Telephone Number, Including Area Code)
I. CHANGE IN NUMBER OF SHARES OUTSTANDING
Indicate any change (increase or decrease) of 5% or more in the number of
shares outstanding:
1. Title of Security: Common Stock
2. Number of shares outstanding before the change: 6,007,315
3. Number of shares outstanding after the change: 6,711,582
4. Effective date of change: May 1996 through July 1996
5. Method of change:
Specify method (such as merger, acquisition, exchange, distribution, stock
split, reverse split, acquisition of stock for treasury, etc.)
Original Issuances
Give brief description of transaction: Between May 1996 and July 1996, an
aggregate of 10,000 shares were issued in capital raising transactions not
involving a public offering. In addition, 236,668 shares were issued for
services rendered, 151,386 shares were issued upon conversion of outstanding
shares of the Company's Series B Convertible Redeemable Preferred Stock
and 306,213 shares were issued upon conversion of an outstanding convertible
note.
II. CHANGE IN NAME OF ISSUER
1. Name prior to change
2. Name after change
3. Effective date of charter amendment changing name
4. Date of shareholder approval of change, if required
Date: July 24, 1996 /s/ James W. Goodchild
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JAMES W. GOODCHILD, Chief Operating and
Financial Officer
