-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, AZfXAmOcMLP7RH9IVf2WTdgYO8ySGc3f2zQZO0/wVC9gd7KbrJ1uaZr9NtA9Aiik G0y7iT0m5/+vSDfqv0zmYw== 0001036050-01-000168.txt : 20010209 0001036050-01-000168.hdr.sgml : 20010209 ACCESSION NUMBER: 0001036050-01-000168 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010208 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: NUTRISYSTEM COM INC CENTRAL INDEX KEY: 0001096376 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-BUSINESS SERVICES, NEC [7389] IRS NUMBER: 233012204 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-58605 FILM NUMBER: 1528874 BUSINESS ADDRESS: STREET 1: 202 WELSH RD CITY: HORSHAM STATE: PA ZIP: 19044 MAIL ADDRESS: STREET 1: 202 WELSH RD CITY: HORSHAM STATE: PA ZIP: 19044 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HAVESON BRIAN D CENTRAL INDEX KEY: 0001133962 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 202 WELSH ROAD CITY: HORSHAM STATE: PA ZIP: 19044 BUSINESS PHONE: 2157065331 SC 13G 1 0001.txt SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. ______)* Nutri/System, Inc. ------------------ (Name of Issuer) Common Stock, $.001 par value ----------------------------- (Title of Class of Securities) 67069D 10 8 ------------------------ (CUSIP Number) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [_] Rule 13d-1(b) [_] Rule 13d-1(c) [X] Rule 13d-1(d) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). Page 1 of 6 pages SCHEDULE 13G - ---------------------------- ---------------------- CUSIP No. 67069D 10 8 Page 2 of 6 Pages ----------- - - - ---------------------------- ---------------------- - ------------------------------------------------------------------------------ NAME OF REPORTING PERSON 1 S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Brian D. Haveson - ------------------------------------------------------------------------------ CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (See Instructions) 2 (a) [_] (b) [_] - ------------------------------------------------------------------------------ SEC USE ONLY 3 - ------------------------------------------------------------------------------ CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States of America - ------------------------------------------------------------------------------ SOLE VOTING POWER 5 NUMBER OF 7,336,500 shares of Common Stock, $.001 par value. SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 OWNED BY 42,000 shares of Common Stock, $.001 par value.(1) ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING 7,336,500 shares of Common Stock, $.001 par value. PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 42,000 shares of Common Stock, $.001 par value.(1) - ------------------------------------------------------------------------------ AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 7,378,500 shares of Common Stock, $.001 par value.(1) - ------------------------------------------------------------------------------ CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES 10 (See Instructions) N/A - ------------------------------------------------------------------------------ PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 11 25.7% - ------------------------------------------------------------------------------ TYPE OF REPORTING PERSON (See Instructions) 12 IN - ------------------------------------------------------------------------------ (1) Of the 42,000 shares appearing in items 6 and 8 and included in item 9, 14,000 are owned by Mr. Haveson's wife and 14,000 shares are owned by each of his two daughters. Mr. Haveson disclaims beneficial ownership of the shares held by his wife and daughters. CUSIP No. 67069D 10 8 Page 3 of 6 Pages - --------------------- ----------------- SCHEDULE 13G This Schedule 13G is being filed for the year ended December 31, 2000. Item 1(a). Name of Issuer. Nutri/System, Inc. Item 1(b). Address of Issuer's Principal Executive Offices. 202 Welsh Road, Horsham, PA 19044. Item 2(a). Name of Person Filing. Brian D. Haveson. Item 2(b). Address of Principal Business Office or, If None, Residence. 202 Welsh Road, Horsham, PA 19044. Item 2(c). Citizenship. United States of America. Item 2(d). Title of Class of Securities. Common Stock, $.001 par value ("Common Stock"). Item 2(e). CUSIP Number. 67069D 10 8. Item 3. If this statement is filed pursuant to Rule 13d-1(b) or 13d-2(b) or (c), check whether the person filing is a: Not applicable. CUSIP No. 67069D 10 8 Page 4 of 6 Pages - --------------------- ----------------- Item 4. Ownership. (a) Amount Beneficially Owned: As of December 31, 2000, Brian D. Haveson might be deemed to have beneficial ownership of 7,378,500 shares of the Issuer's outstanding shares of Common Stock. (b) Percent of Class: As of December 31, 2000, Brian D. Haveson might be deemed to have beneficial ownership of 25.7% of the Issuer's outstanding shares of Common Stock. (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote: 7,336,500 shares of Common Stock. (ii) shared power to vote or to direct the vote: 42,000 shares of Common Stock. Of these shares 14,000 shares are owned by Mr. Haveson's wife and 14,000 shares are owned by each of his two daughters. Mr. Haveson disclaims beneficial ownership of the shares held by his wife and daughters. (iii) sole power to dispose or to direct the disposition of: 7,336,500 shares of Common Stock, as described under Item 4(c)(i) above. (iv) shared power to dispose or to direct the disposition of: 42,000 shares of Common Stock, as described under Item 4(c)(i) above. Item 5. Ownership of Five Percent or Less of a Class. Not Applicable. Item 6. Ownership of More Than Five Percent on Behalf of Another Person. Not Applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Not applicable. CUSIP No. 67069D 10 8 Page 5 of 6 Pages - --------------------- ----------------- Item 8. Identification and Classification of Members of the Group. Not applicable. Item 9. Notice of Dissolution of Group. Not applicable. Item 10. Certification. Not applicable. CUSIP N0. 67069D 10 8 Page 6 of 6 Pages - --------------------- ----------------- Signature. - --------- After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. February 1, 2001 - ---------------- Date Signature /s/ Brian D. Haveson - ------------------------------ Name/Title CEO -----END PRIVACY-ENHANCED MESSAGE-----