-----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, BlFkbsiRO/4wAmWUewS/26VJAZNHixJLdEZDmpQUhzgDnQPA27FtZAbYhBVlJVmD H4bPMrxOt1Qa6BwygZ+mXw== 0001047469-98-037714.txt : 19981021 0001047469-98-037714.hdr.sgml : 19981021 ACCESSION NUMBER: 0001047469-98-037714 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19981020 SROS: NASD GROUP MEMBERS: ATLANTIS EQUITIES, INC. GROUP MEMBERS: ELLIN ROBERT S GROUP MEMBERS: ROBERT ELLIN FAMILY 1997 TRUST GROUP MEMBERS: ROBERT ELLIN PROFIT SHARING PLAN SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FORWARD INDUSTRIES INC CENTRAL INDEX KEY: 0000038264 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS PRODUCTS, NEC [3089] IRS NUMBER: 131950672 STATE OF INCORPORATION: NY FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: SEC FILE NUMBER: 005-45773 FILM NUMBER: 98728060 BUSINESS ADDRESS: STREET 1: 400 POST AVENUE CITY: WESTBURY STATE: NY ZIP: 11590 BUSINESS PHONE: 5163380700 MAIL ADDRESS: STREET 1: 400 POST AVENUE CITY: WESTBURY STATE: NY ZIP: 11590 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: ELLIN ROBERT S CENTRAL INDEX KEY: 0001071292 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: 750 LEXINGTON AVE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2127505858 MAIL ADDRESS: STREET 1: 750 LEXINGTON AVE CITY: NEW YORK STATE: NY ZIP: 10022 SC 13D/A 1 SC 13D/A UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13D (Amendment No. 1) Under the Securities Exchange Act of 1934 FORWARD INDUSTRIES, INC. - -------------------------------------------------------------------------------- (Name of Issuer) COMMON STOCK (.01 PAR VALUE) - -------------------------------------------------------------------------------- (Title of Class of Securities) 34986210 -------------------- (CUSIP Number) Kenneth Koch, Esq. Squadron, Ellenoff, Plesent & Sheinfeld, LLP 551 Fifth Avenue, New York, NY 10176 - -------------------------------------------------------------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) October 9, 1998 ------------------------------------------ (Date of event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(b)(3) or (4), check the following box: / / NOTE: Six copies of this statement, including all exhibits, should be filed with the Commission. See Rule 13d-1(a) for other parties to whom copies are to be sent. * 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).
CUSIP No. 34986210 - ------------------ 1 Name of Reporting Person Robert S. Ellin S.S. or I.R.S. Identification No. of Above Person ------------------------------------------------------------------------------------------- 2 Check the Appropriate Box if (a) [ ] a Member of a Group (b) [X ------------------------------------------------------------------------------------------- 3 SEC Use Only ------------------------------------------------------------------------------------------- 4 Source of Funds PF ------------------------------------------------------------------------------------------- 5 Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e) [ ] ------------------------------------------------------------------------------------------- 6 Citizenship or Place of Organization U.S.A. ------------------------------------------------------------------------------------------- 7 Sole Voting Power 125,500 shares including 108,000 shares underlying warrants ----------------------------------------------------------------- Number of Shares 8 Shared Voting Power 378,500 shares including 181,500 shares underlying warrants Beneficially Owned by ----------------------------------------------------------------- Reporting Person With 9 Sole Dispositive Power 125,500 shares including 108,000 shares underlying warrants ----------------------------------------------------------------- 10 Shared Dispositive Power 378,500 shares including 181,500 shares underlying warrants ------------------------------------------------------------------------------------------- 11 Aggregate Amount Beneficially Owned By Each Reporting Person 504,000 shares ------------------------------------------------------------------------------------------- 12 Check box if the aggregate Amount in Row (11) Excludes Certain Shares [X] ------------------------------------------------------------------------------------------- 13 Percent of Class Represented Amount in Row (11) 9.6% ------------------------------------------------------------------------------------------- 14 Type of Reporting Person IN -------------------------------------------------------------------------------------------
CUSIP No. 34986210 - ------------------ 1 Name of Reporting Person Robert Ellin Family 1997 Trust S.S. or I.R.S. Identification No. of Above Person ------------------------------------------------------------------------------------------- 2 Check the Appropriate Box if (a) [ ] a Member of a Group (b) [X] ------------------------------------------------------------------------------------------- 3 SEC Use Only ------------------------------------------------------------------------------------------- 4 Source of Funds PF ------------------------------------------------------------------------------------------- 5 Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e) [ ] ------------------------------------------------------------------------------------------- 6 Citizenship or Place of Organization U.S.A. ------------------------------------------------------------------------------------------- 7 Sole Voting Power 37,500 shares ----------------------------------------------------------------- Number of Shares 8 Shared Voting Power Beneficially Owned by ----------------------------------------------------------------- Reporting Person With 9 Sole Dispositive Power 37,500 shares ----------------------------------------------------------------- 10 Shared Dispositive Power ------------------------------------------------------------------------------------------- 11 Aggregate Amount Beneficially Owned By Each Reporting Person 37,500 shares ------------------------------------------------------------------------------------------- 12 Check box if the aggregate Amount in Row (11) Excludes Certain Shares [ ] ------------------------------------------------------------------------------------------- 13 Percent of Class Represented Amount in Row (11) 0.7% ------------------------------------------------------------------------------------------- 14 Type of Reporting Person 00 -------------------------------------------------------------------------------------------
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CUSIP No. 34986210 - ------------------ 1 Name of Reporting Person Atlantis Equities, Inc. S.S. or I.R.S. Identification No. of Above Person ------------------------------------------------------------------------------------------- 2 Check the Appropriate Box if (a) [ ] a Member of a Group (b) [X] ------------------------------------------------------------------------------------------- 3 SEC Use Only ------------------------------------------------------------------------------------------- 4 Source of Funds WC ------------------------------------------------------------------------------------------- 5 Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e) [ ] ------------------------------------------------------------------------------------------- 6 Citizenship or Place of Organization New York ------------------------------------------------------------------------------------------- 7 Sole Voting Power ----------------------------------------------------------------- Number of Shares 8 Shared Voting Power 295,500 shares including 106,500 shares underlying warrants Beneficially Owned by ----------------------------------------------------------------- Reporting Person With 9 Sole Dispositive Power ----------------------------------------------------------------- 10 Shared Dispositive Power 295,500 shares including 106,500 shares underlying warrants ------------------------------------------------------------------------------------------- 11 Aggregate Amount Beneficially Owned By Each Reporting Person ------------------------------------------------------------------------------------------- 12 Check box if the aggregate Amount in Row (11) Excludes Certain Shares [ ] ------------------------------------------------------------------------------------------- 13 Percent of Class Represented Amount in Row (11) 5.8% ------------------------------------------------------------------------------------------- 14 Type of Reporting Person CO -------------------------------------------------------------------------------------------
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CUSIP No. 34986210 - ------------------ 1 Name of Reporting Person Robert Ellin Profit Sharing Plan S.S. or I.R.S. Identification No. of Above Person ------------------------------------------------------------------------------------------- 2 Check the Appropriate Box if (a) [ ] a Member of a Group (b) [X] ------------------------------------------------------------------------------------------- 3 SEC Use Only ------------------------------------------------------------------------------------------- 4 Source of Funds 00 ------------------------------------------------------------------------------------------- 5 Check if Disclosure of Legal Proceedings is Required Pursuant to Items 2(d) or 2(e) [ ] ------------------------------------------------------------------------------------------- 6 Citizenship or Place of Organization U.S.A. ------------------------------------------------------------------------------------------- 7 Sole Voting Power ----------------------------------------------------------------- Number of Shares 8 Shared Voting Power 83,000 shares including 75,000 Beneficially Owned by shares underlying warrants ----------------------------------------------------------------- Reporting Person With 9 Sole Dispositive Power ----------------------------------------------------------------- 10 Shared Dispositive Power 83,000 shares including 75,000 shares underlying warrants ------------------------------------------------------------------------------------------- 11 Aggregate Amount Beneficially Owned By Each Reporting Person ------------------------------------------------------------------------------------------- 12 Check box if the aggregate Amount in Row (11) Excludes Certain Shares [ ] ------------------------------------------------------------------------------------------- 13 Percent of Class Represented Amount in Row (11) 1.6% ------------------------------------------------------------------------------------------- 14 Type of Reporting Person EP -------------------------------------------------------------------------------------------
- 5 - This Amendment No. 1 to Schedule 13D, dated October 9, 1998, amends the Schedule 13D dated September 16, 1998 (the "Original 13D"), filed by Robert S. Ellin, Robert Ellin Family 1997 Trust, Atlantis Equities, Inc. and Robert Ellin Profit Sharing Plan (the "Filing Persons") and relates to the common stock, par value $.01 per share ("Common Stock"), of Forward Industries, Inc., a New York corporation (the "Company"). Capitalized terms used herein and not defined herein shall have the meanings ascribed to them in the Schedule 13D dated September 16, 1998. Item 4. PURPOSE OF TRANSACTION. As previously disclosed, Mr. Ellin introduced the Company to Jerome E. Ball, who joined the Company as its Chief Executive Officer in October 1998. Mr. Ellin will be compensated by the Company for such introduction. Item 5. INTEREST IN SECURITIES OF THE ISSUER. Item 5(a) is hereby amended and supplemented by adding the following thereto: (a) The Private Placement Warrants become exercisable on December 9, 1998, which is within 60 days of the date of this report. Mr. Ellin, Atlantis and the Plan own Private Placement Warrants to purchase 108,000, 15,000 and 75,000 shares of Common Stock, respectively. These equity securities, in addition to the 343,500 shares of Common Stock previously reported as beneficially owned by the Filing Persons in the Original 13D, represent approximately 10.3% of the outstanding shares of Common Stock of the Company. - 6 - SIGNATURE --------- After reasonable inquiry and to the best of my knowledge and belief, the undersigned certifies that the information set forth in this statement is true, correct and complete. Dated: October 19, 1998 /s/ Robert S. Ellin ------------------------------ Robert S. Ellin ROBERT ELLIN FAMILY 1997 TRUST By: /s/ Marvin Ellin -------------------------- Marvin Ellin, Trustee ATLANTIS EQUITIES, INC., By: /s/ Robert S. Ellin -------------------------- Robert S. Ellin, President ROBERT ELLIN PROFIT SHARING PLAN By: /s/ Robert S. Ellin -------------------------- Robert S. Ellin, Trustee -----END PRIVACY-ENHANCED MESSAGE-----