FORM 4
(x) Check this box if no longer
subject to Section 16. Form 4
or Form 5 obligations may continue.
See Instruction 1(b).
U.S. SECURITIES AND EXCHANGE COMMISSION _____________________
WASHINGTON, D.C. 20549 | OMB APPROVAL |
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |_____________________|
|OMB NUMBER: 3235-0287|
|EXPIRES: |
| SEPTEMBER 30, 1998 |
Filed pursuant to Section 16(a) of the |ESTIMATED AVERAGE |
Securities Exchange Act of 1934, |BURDEN HOURS |
Section 17(a) of the Public Utility |PER RESPONSE 0.5 |
Holding Company Act of 1935 |_____________________|
or Section 30(f) of the Investment
Company Act of 1940
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1. Name and Address of Reporting Person
William D. Birch
1010 Fifth Avenue
New York, New York 10028
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2. Issuer Name and Ticker or Trading Symbol
Financial Services Acquisition Corporation
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3. IRS OR SOCIAL SECURITY NUMBER OF REPORTING PERSON (VOLUNTARY)
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4. Statement for Month/Year
September, 1996
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5. If Amendment, Date of Original (Month/Year)
January, 1995
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6. Relationship of reporting person to Issuer (Check all applicable)
( ) DIRECTOR
( ) 10% OWNER
( ) OFFICER (GIVE TITLE BELOW)
( x ) OTHER (SPECIFY TITLE BELOW)
Former Director
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7. Individual, or Joint/Group Filing (Check all applicable)
( x ) Form filed by One Reporting Person
( ) Form filed by More than One Reporting Person
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TABLE I
Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1. Title of Security (Instr. 3)
Common Stock, $.001 par value
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2. Transaction Date (Month/Day/Year)
12/07/94
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3. Transaction Code (Instr. 8)
P
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4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5)
84,000*
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5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4)
109,000
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6. Ownership Form: Direct(D) or Indirect(I) (Instr. 4)
(D)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Reminder: Report on a separate line for each class of securities
beneficially owned directly or indirectly.
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TABLE II
Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., Puts, Calls, Warrants, Options, Convertible securities)
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1. Title of Derivative Security (Instr. 3)
(1) Redeemable Common Stock Purchase Warrants
(2) Redeemable Common Stock Purchase Warrants
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2. Conversion or Exercise Price of Derivative Security
(1) $5.00
(2) $5.00
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3. Transaction Date (Month/Day/Year)
(1) 12/7/94
(2) 12/12/94
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4. Transaction Code (Instr. 8)
(1) P
(2) P
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
(1) 168,000
(2) 100,000
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6. Date Exercisable and Expiration Date (Month/Day/Year)
(1) Each Warrant is currently exercisable
Expiration Date 11/30/01
(2) Each Warrant is currently exercisable
Expiration Date 11/30/01
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7. Title and Amount of Underlying Securities (Instr. 3 and 4)
(1) Common Stock
168,000 Shares
(2) Common Stock
100,000 Shares
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8. Price of Derivative Securities (Instr. 5)
(1) *
(2) $.91
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9. Number of Derivative Securities Beneficially Owned at End of Month
(Instr. 4)
(1) 268,000
(2) 268,000
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10. Ownership Form of Derivative Security: Direct(D) or Indirect(I)
(Instr. 4)
(1) (D)
(2) (D)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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EXPLANATION OF RESPONSES:
* The reported securities are included within 84,000 Units purchased by
the reporting person for $6.00 per Unit. Each Unit consists of one share
of Common Stock and two Redeemable Common Stock Purchase Warrants.
/s/ William D. Birch 9/10/96
** SIGNATURE OF REPORTING PERSON DATE
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** INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACTS CONSTITUTE FEDERAL
CRIMINAL VIOLATIONS. SEE 18 U.S.C. 1001 AND 15 U.S.C. 78FF(A).
