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