0001140361-11-057499.txt : 20111214
0001140361-11-057499.hdr.sgml : 20111214
20111214181449
ACCESSION NUMBER: 0001140361-11-057499
CONFORMED SUBMISSION TYPE: 5
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20111030
FILED AS OF DATE: 20111214
DATE AS OF CHANGE: 20111214
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Shaw Deborah
CENTRAL INDEX KEY: 0001366962
FILING VALUES:
FORM TYPE: 5
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-09232
FILM NUMBER: 111261954
MAIL ADDRESS:
STREET 1: 2908 MAPLE AVENUE
CITY: MANHATTAN BEACH
STATE: CA
ZIP: 90266
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: VOLT INFORMATION SCIENCES, INC.
CENTRAL INDEX KEY: 0000103872
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-HELP SUPPLY SERVICES [7363]
IRS NUMBER: 135658129
STATE OF INCORPORATION: NY
FISCAL YEAR END: 1031
BUSINESS ADDRESS:
STREET 1: 1065 AVENUE OF THE AMERICAS
STREET 2: 20TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10018
BUSINESS PHONE: 212-704-2400
MAIL ADDRESS:
STREET 1: 1065 AVENUE OF THE AMERICAS
STREET 2: 20TH FLOOR
CITY: NEW YORK
STATE: NY
ZIP: 10018
FORMER COMPANY:
FORMER CONFORMED NAME: VOLT INFORMATION SCIENCES INC
DATE OF NAME CHANGE: 19920703
FORMER COMPANY:
FORMER CONFORMED NAME: VOLT TECHNICAL CORP
DATE OF NAME CHANGE: 19680913
5
1
doc1.xml
FORM 5
X0304
5
2011-10-30
0
0
0
0000103872
VOLT INFORMATION SCIENCES, INC.
VISI
0001366962
Shaw Deborah
2908 MAPLE AVENUE
MANHATTAN BEACH
CA
90266
1
0
0
0
Common Stock, $0.10 par value
320416
D
Common Stock, $0.10 par value
2010-12-01
5
G
0
230142
0
D
1332369
I
By GRATs
Common Stock, $0.10 par value
2011-06-09
5
G
0
29688
0
D
1262857
I
By GRATs
Common Stock, $0.10 par value
71220
I
As custodian
Common Stock, $0.10 par value
23019
I
By Spouse
Common Stock, $0.10 par value
34584
I
By Spouse as custodian
Common Stock, $0.10 par value
2010-12-01
5
G
0
230142
0
A
230142
I
By Spouse as Co-Trustee
Common Stock, $0.10 par value
2011-06-09
5
G
0
29688
0
A
259830
I
By Spouse as Co-Trustee
Stock Option (Right to Buy)
6.39
2019-04-06
Common Stock, $0.10 par value
3000
3000
D
Column 5 of Table 1 gives effect to all transactions, including contributions to, and all annuity distributions from, Grantor Retained Annuity Trusts ("GRATs") created by the reporting person through the date set forth in Column 2 (except that the final amount shown as owned directly or through GRATs is at the end of the fiscal year covered by this Report). Certain of the transactions may not be reportable and, therefore, amounts shown in Column 5 may not foot to the amount previously reported as owned.
Held by Grantor Retained Annuity Trusts ("GRATs") created by, and the sole trustee and sole annuitant of which is, the reporting person are exempt from reporting pursuant to Rule 16a-13.
Held by the reporting person as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
The filing of this statement shall not be construed as an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of these securities.
Held by the reporting person's spouse and his sister as co-trustees of trusts for the benefit of the children of the reporting person.
Held by the reporting person's spouse as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
The option is exercisable in 20% annual installments, on a cumulative basis, commencing April 7, 2010, one year after the date of grant of the option.
/s/ Deborah Shaw
2011-12-14