0001140361-11-057509.txt : 20111214 0001140361-11-057509.hdr.sgml : 20111214 20111214182255 ACCESSION NUMBER: 0001140361-11-057509 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: GOODMAN BRUCE G CENTRAL INDEX KEY: 0001229203 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09232 FILM NUMBER: 111261970 MAIL ADDRESS: STREET 1: HINKLEY ALLEN & SNYDER LLP STREET 2: 28 STAT STREET CITY: BOSTON STATE: MA ZIP: 02109 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 0001229203 GOODMAN BRUCE G SHEPHERD KAPLAN LLC 125 SUMMER STREET BOSTON MA 02110 1 0 0 0 Common Stock, $0.10 par value 19244 D Common Stock, $0.10 par value 1500 I As Trustee Common Stock, $0.10 par value 2010-11-18 5 G 0 230142 0 A 230142 I As Co-Trustee Common Stock, $0.10 par value 2011-07-22 5 G 0 5474 0 A 48956 I A Co-Trustee Common Stock, $0.10 par value 2011-07-22 5 G 0 5474 0 D 304886 I By Spouse Common Stock, $0.10 par value 2010-11-18 5 G 0 230142 0 D 1358416 I By Spouse's GRATs Stock Option (Right to Buy) 6.39 2019-04-06 Common Stock, $.10 par value 3000 3000 D 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 as trustee of an irrevocable trust for the benefit of a child of reporting person. Distributed to the reporting person and the sister (who is a director of the issuer) of the spouse of the reporting person, as co-trustees of a trust for the benefit of children of the reporting person upon termination of two Grantor Retained Annuity Trusts created by, and the sole trustee and annuitant of which was, the spouse of the reporting person. Held by the reporting person, the spouse of the reporting person and the sister (who is a director of the issuer) of the spouse of reporting person, as co-trustees of trusts for the benefit of children of the reporting person. 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's spouse 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 GRATs created by, and the sole trustee and sole annuitant of which is, the reporting person's spouse. Contributions to the GRATs by, and annuity distributions to, the reporting person's spouse are exempt from reporting pursuant to Rule 16a-13. This 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/ Bruce G. Goodman 2011-12-14