SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
GOODMAN BRUCE G

(Last) (First) (Middle)
SHEPHERD KAPLAN LLC
125 SUMMER STREET

(Street)
BOSTON MA 02110

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
VOLT INFORMATION SCIENCES, INC. [ VISI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
11/02/2014
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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 (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock, $0.10 par value 21,744 D
Common Stock, $0.10 par value 01/14/2014 G 309,207 A(1) $0 1,442,239 I By Spouse(2)
Common Stock, $0.10 par value 01/14/2014 G 120,849 D(3) $0 1,321,390 I By Spouse(2)
Common Stock, $0.10 par value 01/14/2014 G 120,849 A(3) $0 557,054 I As Co-Trustee(2)(4)
Common Stock, $0.10 par value 09/29/2014 G 5,400 D(5) $0 1,315,990 I By Spouse(2)
Common Stock, $0.10 par value 09/29/2014 G 5,400 A(5) $0 69,356 I As Co-Trustee(2)(6)
Common Stock, $0.10 par value 1,500 I As Co-Trustee(7)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $6.39 (8) 04/06/2019 Common Stock, $.10 par value 3,000 3,000 D
Explanation of Responses:
1. Distributed to the spouse of reporting person as a result of the termination of Grantor Retained Annuity Trusts.
2. 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.
3. Distributed to 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 spouse of the reporting person upon gift from the spouse of the reporting person.
4. Held by 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 spouse of the reporting person.
5. Distributed to 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 spouse of the reporting person upon gift from the spouse of the reporting person.
6. 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 spouse of the reporting person.
7. Held by the reporting person as trustee of an irrevocable trust for the benefit of a child of reporting person.
8. This option became exercisable in 20% annual installments, on a cumulative basis, commencing April 7, 2010, one year after the date of grant of the option.
Remarks:
/s/ Bruce G. Goodman 12/17/2014
** Signature of Reporting Person Date
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).
** 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 is insufficient, see Instruction 6 for procedure.
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 Number.