4 1 tombari4_sep.txt 4
------ -------------------------------- FORM 4 OMB APPROVAL ------ -------------------------------- OMB Number: 3235-0287 [ ] Check this box if no longer Expires: January 31, 2005 subject to Section 16. Form 4 Estimated average burden or Form 5 obligations may hours per response..........0.5 continue. See Instruction 1(b) -------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 (Print or Type Responses) ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to Issuer Online Gaming Systems, Ltd. (Check all applicable) Tombari, Lawrence P. OGAM -------------------------------------------------------------------------------------------- (Last) (First) (Middle) 3. IRS Identifi- 4. Statement for Month/Day/Year [X] Director [ ] 10% Owner cation Number [X] Officer [ ] Other of Reporting (give title (specify below) Person, if an below) entity c/o Online Gaming Systems, Ltd. (voluntary) President & CFO 3225 McLeod Drive 1st Floor September 2002 --------------------------------------- ------------------------------------------------------------------------ (Street) 5. If Amendment, Date of 7. Individual or Joint/Group Filing Original (Month/Day/Year) (check applicable line) [X] Form Filed by One Reporting Person [ ] Form Filed by More than One Las Vegas, NV 89121 Reporting Person ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ------------------------------------------------------------------------------------------------------------------------------------ 1. Title 2. Trans- 2A.Deemed 3.Trans- 4. Securities Acquired (A) 5. Amount of 6. Ownership Form: 7. Nature of of action Execution action or Disposed of (D) Securities Direct (D) or Indirect Security Date Date,if Code (Instr. 3,4 and 5) Beneficially Indirect (I) Beneficial (Instr.3) any (Instr.8) Owned Following (Instr. 4) Ownership (Month/Day/ Reported (Instr. 4) (Month/ Year) Transaction(s) Day/Year) (Instr. 3 and 4) -------------------------------------------- Code V Amount (A) or (D) Price ----------------------------------------------------------------------------------------------------------------------------------- Common Stock 09/20/02 P 50,000 A $.06 633,333 D ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- 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). Potential 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 control number. (Over) SEC 1474 (9-02)
FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (E.G., puts, calls, warrants, options, convertible securities) -------------------------------------------------------------------------------------- 1. Title of 2. Conversion 3. Transaction 3A.Deemed 4. Transaction 5. Number of Derivative or Exercise Date Execution Code Derivative Security Price of (Month/Day/ Date, if (Instr. 8) Securities (Instr. 3) Derivative Year) any Acquired (A) Security (Mo/Dy/Yr) or Disposed of (D) (Instr. 3, 4, and 5) -------------------------------------- Code V (A) (D) --------------------------------------------------------------------------------------------------- Option (to buy) $.03 09/20/02 A(1) 20,000 --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------
FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (E.G., puts, calls, warrants, options, convertible securities) ----------------------------------------------------------------------------------------------------------- 6. Date 7. Title and Amount 8. Price of 9. Number of 10. Ownership 11. Nature of Exercisable of Underlying Derivative Derivative Form of Indirect and Expiration Securities Security Securities Derivative Beneficial Date (Instr. 3 and 4) Beneficially Security: Ownership (Month/Day/Year) (Instr. 5) Owned Follow- Direct (D) or (Instr. 4) ing Reported Indirect (I) Transactions(s) (Instr. 4) (Instr. 4) ------------------------------------------ Amount Date Expir- or Exer- ation Number cisable Date Title of Shares ----------------------------------------------------------------------------------------------------------- 09/20/02 09/20/07 Common 20,000 253,352 D Stock ----------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------- -----------------------------------------------------------------------------------------------------------
Explanation of Responses: (1) Granted pursuant to Employment Agreement /s/ LAWRENCE P. TOMBARI 10/25/02 ------------------------------- ------------------ **Signature of Reporting Person Date ** 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 provided is insufficient, see Instruction 6 for procedure.