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- ------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------
Washington, D.C. 20549
FORM 5 OMB APPROVAL
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL
- ------------------------ OWNERSHIP ----------------------------
/X/ Check box if no OMB Number: 3235-0362
longer subject to Filed pursuant to Section 16(a) of the Expires: September 30, 1998
Section 16. Form 4 Securities Exchange Act of 1934, Section 17(a) Estimated average
or Form 5 of the Public Utility Holding Company Act of burden hours per
obligations may 1935 or Section 30(f) of the Investment Company response............... 1.0
continue. See Act of 1940 ----------------------------
Instruction 1(b).
/_/ Form 3 Holdings
Reported
/_/ Form 4 Transactions
Reported
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1. Name and Address of 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer
Reporting Person*
(Check all applicable)
BLACK EMILIA F. Trend-Lines, Inc. "TRND" _____ Director __X__ 10% Owner
_____ Officer (give _____ Other (specify
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(Last) (First) (Middle) 3. IRS or Social Security 4. Statement for below)
Number of Reporting Month/Year
Trend-Lines, Inc. Person (Voluntary)
135 American Legion Highway 2/26/00
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(Street) 5. If Amendment, 7. Individual or Joint/Group Reporting
Date of
(check applicable line)
Original _____ Form Filed by One Reporting Person
Revere MA 02151 (Month/Year) _____ Form Filed by More than One Reporting Person
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(City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1. Title of Security 2. Transaction 3. Transaction 4. Securities 5. Amount of 6. Ownership 7. Nature of
(Instr. 3) Date Code Acquired (A) Securities Form: Indirect
(Month/ (Instr. 8) or Disposed Beneficially Direct (D) Beneficial
Day/ of (D) Owned at end or Ownership
Year) (Instr. 3, of Issuer's Indirect (I) (Instr. 4)
4, and 5) Fiscal Year (Instr. 4)
------------------- (Instr. 3 and 4)
(A)
or
Amount (D) Price
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Class A Common Stock 8/9/99 G 30,000 D -0- 2,409,609 * *
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*See Attached Schedule A
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*If the form is filed by more than one reporting person, see instruction 4(b)(v). (Over)
SEC 2270 (7-96)
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FORM 5 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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1. Title 2. Conver- 3. Trans- 4. Trans- 5. Number of 6. Date 7. Title 8. Price 9. Number 10. Owner- 11. Nature
of sion of action action Derivative Exercis and of of ship of of
Deriva Exercise Date Code Securities -able Amount Deriva- Deriv- Deriva- Indirect
-tive Price of (Month/ (Instr. Acquired and of tive ative tive Ownership
Security Deriva- Day/ 8) (A) or Expira Under- Secur- Secur- Secur- (Instr.
(Instr. 3) tive Year) Disposed -tion lying ity ities ity: 4)
Security of (D) Date Secur- (Instr. Benefi- Direct
(Instr. 3, (Month/ ities 5) cially (D) or
4, and 5) Day/ (Instr. Owned at Indirect
Year) 3 and 4) the End (I)
-------------------------- of Year (Instr.
Amount (Instr. 4)
Date or 4)
-------------- Excer- Expira- Number
(A) (D) cis- tion of
able Date Title Shares
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Class B 8/9/99 C 30,000 Class 30,000 2,288,873 * *
Common A
Stock Common
Stock
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Explanation of Responses:
/s/ Emilia F. Black
** Intentional misstatements or omissions of facts ___________________________________ April 10, 2000
constitute Federal Criminal Violations. ** Signature of Reporting Person Date
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Emilia F. Black
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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Potential persons who are to respond to the collection of information contained
in this form are not required to respond unless the form displays a currently
valid OMB number. Page 2
SEC 2270 (7-96)
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AMENDED FORM 5
AMENDED ANNUAL STATEMENT OF
CHANGES IN BENEFICIAL OWNERSHIP
SCHEDULE A
EMILIA F. BLACK
Class A Common Stock Shares Beneficially Owned
Emilia F. Black 2,409,609
Class B Common Stock Shares Beneficially Owned
Emilia F. Black 2,288,873 (1)
(1) Amount Beneficially Owned: Of the 2,409,609 shares of Class A Common
Stock deemed beneficially owned by the reporting person, the reporting
person has the right to acquire 2,288,873 shares upon conversion of such
shares of Class B Common Stock of the issuer as to which the reporting
person may be deemed to be the beneficial owner, which are convertible at
any time into Class A Common Stock on a one to one share basis.
The shares deemed beneficially owned by the reporting person are held of
record by certain trusts of which the reporting person is a trustee,
beneficiary or settlor and a limited partnership of which the reporting
person is a general partner.
Of the 2,409,609 shares of Class A Common Stock deemed beneficially owned
by the reporting person, the reporting person has the sole voting and
investment power with respect to 919,016 shares of Class A Common Stock
deemed beneficially owned by her.
Of the 2,409,609 shares of Class A Common Stock deemed beneficially owned
by the reporting person, the reporting person does not have voting or
investment power with respect to 226,317 shares of Class A Common Stock,
but has the right to acquire such shares in her capacity as settlor of
certain trusts.
The reporting person shares voting and investment power with respect to
1,188,500 shares of Class A Common Stock.
Except for 226,317 shares of Class A Common Stock, the reporting person
disclaims beneficial ownership as to 4,124,119 shares of Class A Common
Stock deemed beneficially owned by the reporting person's spouse.
