FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
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Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
SHELLS SEAFOOD RESTAURANTS INC [ SHLL ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 02/07/2005 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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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) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common | 02/07/2005 | P4 | 93,750 | A | $0.16 | 93,750 | D | ||||||||
Common | 02/07/2005 | P4 | 4,688 | A | $0.16 | 98,438 | I | See Footnote(1) | |||||||
Common | 02/07/2005 | P4 | 193,751 | A | $0.16 | 292,189 | I | See Footnote(2) | |||||||
Common | 11/01/2005 | P4 | 463,800 | A | $0(3) | 755,989 | I | See Footnote(3) | |||||||
Common | 11/12/2006 | P4 | 99,000 | A | $0.75 | 854,989 | I | See Footnote(4) |
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) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Stock Option to purchase Common Stock $0.01 par value | $0.85 | 06/22/2005 | 4A | 20,000 | 07/22/2005 | 06/22/2012 | Common Stock | 20,000 | $0.85 | 20,000 | D | |||
Stock Option to purchase Common Stock | $0.76 | 06/13/2005 | 06/22/2005 | 4A | 20,000 | 12/31/2005 | 06/13/2012 | Common Stock | 20,000 | $0.76 | 40,000 | D | ||
Stock Option to purchase Common Stock $0.01 par value | $0.75 | 02/01/2005 | 06/22/2005 | 4A | 20,000 | 02/01/2006 | 02/01/2015 | Common Stock | 20,000 | $0.75 | 60,000 | D | ||
Stock Option to purchase Common Stock $0.01 par value | $0.75 | 05/15/2006 | 06/22/2005 | 4A | 20,000(5) | 02/01/2006 | 05/18/2016 | Common Stock | 20,000 | $0.75 | 80,000(5) | D |
Explanation of Responses: |
1. Shares held by Mr. Herman's dependent child. |
2. 50% of these shares are owned by Mr. Herman through Galloway Capital Management LLC, of which Mr. Herman is a managing member. |
3. Shares owned by Strategic Turnaround Equity Partners, L.P (Cayman) ("STEP"), an investment fund. These shares were primarily acquired through transfers of securities to the Fund by various limited partners. Mr. Herman is a managing member of the General Partner of STEP, and accordingly may be deemed to beneficially own the shares in STEP. |
4. Shares acquired by STEP. See footnote (3). |
5. These options vest 1/12 each month, and shall be fully vested on 5/18/07. |
/s/ Gary L. Herman | 01/09/2006 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |