-----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, QMq988x5n2/GHnLDWFvzJ+5570wQyhPPFdyUkapHzuG7hRSpD79widuhI4JeSSu1 rCCkucTglfhq1PE7NfZiOA== 0001045447-01-500052.txt : 20010710 0001045447-01-500052.hdr.sgml : 20010710 ACCESSION NUMBER: 0001045447-01-500052 CONFORMED SUBMISSION TYPE: 5/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000131 FILED AS OF DATE: 20010709 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: QAD INC CENTRAL INDEX KEY: 0001036188 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 770105228 STATE OF INCORPORATION: DE FISCAL YEAR END: 0131 FILING VALUES: FORM TYPE: 5/A SEC ACT: SEC FILE NUMBER: 000-22823 FILM NUMBER: 1676487 BUSINESS ADDRESS: STREET 1: 6450 VIA REAL CITY: CARPINTERIA STATE: CA ZIP: 93013 BUSINESS PHONE: 8056846614 MAIL ADDRESS: STREET 1: 6450 VIA REAL CITY: CARPINTERIA STATE: CA ZIP: 93013 COMPANY DATA: COMPANY CONFORMED NAME: NIEDZIELSKI VINCE P CENTRAL INDEX KEY: 0001102351 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 5/A BUSINESS ADDRESS: STREET 1: 6450 VIA REAL CITY: CARPINTERIA STATE: CA ZIP: 93013 BUSINESS PHONE: 8056846614 MAIL ADDRESS: STREET 1: 6450 VIA REAL CITY: CARPINTERIA STATE: CA ZIP: 93013 5/A 1 niedzielskiform5a-62801.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5/A ANNUAL 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(f) of the Investment Company Act of 1940 [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b) _______________________________________________________________________________ 1. Name and Address of Reporting Person* Niedzielski Vince _______________________________________________________________________________ (Last) (First) (Middle) 6450 Via Real _______________________________________________________________________________ (Street) Carpinteria California 93013 _______________________________________________________________________________ (City) (State) (Zip) _______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol QAD Inc. QADI _______________________________________________________________________________ 3. IRS Identification Number of Reporting Person,if an Entity (Voluntary) _______________________________________________________________________________ 4. Statement for Month/Year _______________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) 01/00 _______________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Executive Vice President - Production _______________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form filed by one Reporting Person [ ] Form filed by more than one Reporting Person Table I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Transaction 3.Transaction 4. Securities Acquired(A) 5. Amount of 6. Ownership 7. Nature (Instr. 3) Date Code or Disposed of (D) Securities Form: of (Month/Date/ (Instr.8) (Instr. 3,4 and 5) Beneficially Direct(D) Indirect Year) A Owned at End or Beneficially or of Year Indirect(I) Ownership Amount D Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. Form 5 (continued) Table II (PART 1) Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) (Columns 1 through 6) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Conversion 3. Transaction 4.Transaction 5. Number of Derivative 6. Date Exercisable and Security or Exercise Date Code Securities Acquired (A) Expiration Date (Instr. 3) Price of (Month/Day/ (Instr. 8) or Disposed of (D) (Month/Date/Year) Derivative Year) (Instr. 3,4 and 5) Date Expiration Security A D Exercisable Date - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option $15.00 2/1/97 A 80,000 + 02/01/05 Stock Option $5.1857 8/13/98 A 15,000 ++ 08/13/06 Stock Option $3.50 3/11/99 A 3,500 * 3/11/03 Stock Option $3.8125 9/15/99 A 40,000 ** 9/15/03 Stock Option $3.5313 10/07/99 A 100 *** 10/07/03 Stock Option $4.625 06/08/00 A 20,000 **** 06/08/08 Stock Option $1.7813 12/1/00 A 25,000 ***** 12/01/08
Table II (PART 2) Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) (Columns 1,3 and 7 through 11) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of 3. Transaction 7. Title and Amount 8. Price 9. Number of 10. Ownership Form of 11. Nature of Derivative Date of Underlying of Derivative Derivative Derivative Indirect Security (Month/Day/Year) Securities Security Securities Security: Beneficial (Instr. 3) (Instr. 3 and 4) (Instr. 5) Beneficially Direct (D) or Ownership Amount or Number Owned at End of Indirect (I) (Instr. 4) Title of Shares Year (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Stock Option 2/1/97 Common Stock 80,000 N/A 80,000 D Stock Option 8/13/98 Common Stock 15,000 N/A 15,000 D Stock Option 3/11/99 Common Stock 3,500 N/A 3,500 D Stock Option 9/15/99 Common Stock 40,000 N/A 40,000 D Stock Option 10/07/99 Common Stock 100 N/A 100 D Stock Option 06/08/00 Common Stock 20,000 N/A 20,000 D Stock Option 12/01/00 Common Stock 25,000 N/A 25,000 D
Explanation of Responses: +Vests 26,667 annually beginning 2/1/98, 2/1/99 and 2/1/00. ++Vests 5,000 annually beginning 8/13/99, 8/13/00, 8/13/01 and 8/13/02. * Vests 875 shares annually beginning 3/11/00, 3/11/01, 3/11/02 and 3/11/03 ** Vests 10,000 shares annually beginning 9/15/00, 9/15/01, 9/15,02 and 9/15/03 *** Vests 25 shares annually beginning 10/07/00, 10/07/01, 10/07/02 and 10/07/03 ****Vests 5,000 shares annually beginning 6/8/01, 6/8/02, 6/8/03 and 6/8/04. *****Vests 5,250 shares annually beginning 12/1/01, 12/1/02, 12/1/03 and 12/1/04 /s/ Vince Niedzielski July 9, 2001 ________________________________ ______________________ **Signature of Reporting Person Date **International 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. 2 -----END PRIVACY-ENHANCED MESSAGE-----