-----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, R0m82me2AcNyzNHYKAZM2o3nbFvuC+tiC8rcw6z78W91XyQ1NJAmBTwvT/d/GptW 3d4aqUr0rafkJGqNpE6eqA== 0001157523-05-007877.txt : 20050902 0001157523-05-007877.hdr.sgml : 20050902 20050902113038 ACCESSION NUMBER: 0001157523-05-007877 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20050330 FILED AS OF DATE: 20050902 DATE AS OF CHANGE: 20050902 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: 1028 BUSINESS ADDRESS: STREET 1: 560 LEXINGTON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022-2928 BUSINESS PHONE: 2127042400 MAIL ADDRESS: STREET 1: 560 LEXINGTON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022-2928 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 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: SHAW JEROME CENTRAL INDEX KEY: 0001007671 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-09232 FILM NUMBER: 051066610 BUSINESS ADDRESS: STREET 1: C/O VOLT INFORMATION SCIENCES INC STREET 2: 1221 AVE OF THE AMERICAS CITY: NEW YORK STATE: NY ZIP: 10020-1579 BUSINESS PHONE: 2127042435 4 1 a4964478_ex.xml X0202 4 2005-03-30 0 0000103872 VOLT INFORMATION SCIENCES, INC. VOL 0001007671 SHAW JEROME C/O VOLT INFORMATION SCIENCES, INC. 2401 NORTH GLASSELL STREET ORANGE CA 92865 0 1 0 0 Executive VP and Secretary Common Stock, $.10 par value 2005-03-30 4 J 0 294502 0 D 2630384 D Common Stock, $.10 par value 2005-03-30 4 J 0 98167 0 A 98167 I As Trustee Common Stock, $.10 par value 2005-03-30 4 J 0 98167 0 A 98167 I As Trustee Common Stock, $.10 par value 2005-03-30 4 J 0 98168 0 A 98168 I As Trustee Common Stock, $.10 par value 6750 I By Spouse Common Stock, $.10 par value 201250 I As Trustee Common Stock, $.10 par value 2870.2573 I By ESOP Common Stock, $.10 par value 20610.068 I By 401(k) Plan Common Stock, $.10 par value 9500 I By Family Foundation Employee Stock Options (Right to Buy) 4/22/96 Grant 18.0833 1997-04-23 2006-04-22 Common Stock 45000 45000 D Includes 2,183,353 shares owned by a revocable trust for the benefit of the undersigned and his wife. The undersigned may demand that the shares be transferred to him at any time. Distributed to the undersigned as co-trustee of a trust for the benefit of a child of Jerome Shaw. The filing of this statement shall not be construed as an admission that the undersigned is, for the purpose of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of these securities. Shares are held by the undersigned and his wife as trustees of an Irrevocable Trust for the benefit of a child of the undersigned and his wife. Held in the undersigned's Employee Stock Ownership Plan account in the Company's Savings Plan as of July 31, 2005, the latest date as of which information is available. Held in the undersigned's Company Stock Fund under the Company's 401 (k) Plan account in the Company's Savings Plan as of July 31, 2005, the latest date as of which information is available. Shares are held in a family foundation. Exercisable one year after grant. /s/ Howard B. Weinreich, Attorney-in-Fact 2005-09-01 -----END PRIVACY-ENHANCED MESSAGE-----