4 1 form4dividend0303.htm Form 4

FORM 4

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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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).

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940

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1. Name and Address of Reporting Person*

Amico, Peter

2. Issuer Name and Ticker or Trading Symbol
Airtrax, Inc. (AITX)

6. Relationship of Reporting Person(s)
to Issuer (Check all applicable)
X   Director                         X   10% Owner
X   Officer (give title below)          Other (specify below)

President

(Last)      (First)     (Middle)

870-B Central Ave

3. I.R.S. Identification Number
of Reporting Person,
if an entity (voluntary)

  

4. Statement for
Month/Day/Year
3/15/03

(Street)

Hammonton,      NJ  08037

5. If Amendment,
Date of Original
(Month/Day/Year)
 

7. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
    Form filed by More than One Reporting Person

(City)     (State)     (Zip)

Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned


1. Title of Security
(Instr. 3)

2. Trans-
action
Date
(Month/ Day/
Year)

2A. Deemed
Execution
Date,
if any
(Month/Day/
Year)

3. Trans-
action Code
(Instr. 8)

4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 & 5)

5. Amount of
Securities
Beneficially
Owned Follow-
ing Reported Transactions(s)
(Instr. 3 & 4)

6. Owner-
ship Form:
Direct (D)
or Indirect (I)
(Instr. 4)

7. Nature of Indirect
Beneficial Ownership
(Instr. 4)

Code

V

Amount

(A)
or
(D)

Price

Common Stock

3/15/03 

3/15/03 

P

 

246,731* 

A

$0.33 per share* 

1,630,623

I

Held by Arcon Corp., and affiliate 

Common Stock

 

 

 

 

 

 

 

280,000

D

 

Common Stock

 

 

 

 

 

 

 

305,737

I

Held by third party

as security for a loan

Voting Preferred Stock

 

 

 

 

 

 

 

275,000

I

Held by Arcon Corp., an affiliate

           
           
           


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).

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 control number


FORM 4 (continued)

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. Conver-
sion or
Exercise
Price of Derivative Security

3. Trans-
action Date

(Month/
Day/
Year)

3A. Deemed
Execution
Date,
if any
(Month/
Day/
Year)

4. Trans-
action
Code

(Instr. 8)

5. Number of Derivative Securities Acquired (A) or Disposed of (D)

(Instr. 3, 4 & 5)

6. Date Exercisable
and Expiration
Date
(Month/Day/
Year)

7. Title and Amount of Underlying Securities
(Instr. 3 & 4)

8. Price of Derivative Security
(Instr. 5)

9. Number of
Derivative
Securities
Beneficially
Owned
Following
Reported Transaction(s)
(Instr. 4)

10. Owner-
ship Form
of Deriv-
ative
Security:
Direct (D)
or Indirect (I)
(Instr. 4)

11. Nature of Indirect Beneficial Ownership
(Instr. 4)

Code

V

(A)

(D)

Date Exer-cisable

Expira-
tion
Date

Title

Amount or Number of
Shares

Preferred Stock Dividend

1/

 

 

 

 

 

 

1/

1/

Common Stock

1/

 

1/

I

Held by Arcon Corp., an affiliate 

                
                
                
                
                


Explanation of Responses:

1/ Arcon Corp. is the holder of 275,000 shares of voting preferred stock of the Issuer. The preferred stock has a stated value per share of $5.00 and an annual dividend per share equal to 5% of the stated value. Dividends are cumulative and the holder has a right with respect to any fiscal quarter to waive any cash dividend for such quarter and receive the dividend in the form of common stock at a price per share equal to 30% of the lowest private offering or trading price of the common stock during such quarter. As of December 31, 2002, accrued dividends under the features of the preferred stock which have not been paid as of such date could result in the issuance of 247,945 shares of common stock to Arcon Corp.


 

By: /s/ Peter Amico

              
**Signature of Reporting Person

3/13/03
Date


**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.