-----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, JBSpwrehjMCoOLhcWZaFDaOKwm4tvPD4+CtkBjzdnkaLBD70sB0OqgtTrncqFK2J W4gI1Tfwv5VCiU+tbuwyYg== 0000922423-01-500198.txt : 20010515 0000922423-01-500198.hdr.sgml : 20010515 ACCESSION NUMBER: 0000922423-01-500198 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010503 FILED AS OF DATE: 20010514 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FAB INDUSTRIES INC CENTRAL INDEX KEY: 0000034136 STANDARD INDUSTRIAL CLASSIFICATION: KNITTING MILLS [2250] IRS NUMBER: 132581181 STATE OF INCORPORATION: DE FISCAL YEAR END: 1130 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-05901 FILM NUMBER: 1633692 BUSINESS ADDRESS: STREET 1: 200 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10016 BUSINESS PHONE: 2122799000 MAIL ADDRESS: STREET 1: 200 MADISON AVE CITY: NEW YORK STATE: NY ZIP: 10016 COMPANY DATA: COMPANY CONFORMED NAME: GOLDBERG MARK CENTRAL INDEX KEY: 0001140580 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O FAB INDUSTRIES INC STREET 2: 200 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10016 MAIL ADDRESS: STREET 1: C/O FAB INDUSTRIES INC STREET 2: 200 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10016 3 1 kl05023_form3.txt FORM 3 --------------------------- OMB APPROVAL FORM 3 OMB Number..3235-0104 Expires:December 31, 2001 Estimated average burden hours per response 0.5 --------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(f) of the Investment Company Act of 1940 1. Name and Address of Reporting Person Goldberg, Mark J. c/o Fab Industries, Inc. 200 Madison Avenue New York, New York 10022 2. Date of Event Requiring Statement (Month/Day/Year) May 3, 2001 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol Fab Industries, Inc. ("FIT") 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) ( ) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Vice President of Operations 6. 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*
- ----------------------------------------------------------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Beneficially Owned | - -----------------------------------------------------------------------------------------------------------------------------------| 1. Title of Security |2. Amount of |3. Ownership |4. Nature of Indirect | | Securities | Form: | Beneficial Ownership | | Beneficially | Direct(D) or | | | Owned | Indirect(I) | | - -----------------------------------------------------------------------------------------------------------------------------------| Common Stock, par value $0.20 per share | 861 | I | By ESOP | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | - -----------------------------------------------------------------------------------------------------------------------------------| *If form is filed by more than one reporting person, see Instruction 5(b)(v). (over) Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. SEC 1473 (7-96)
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- ----------------------------------------------------------------------------------------------------------------------------------- Table II -- Derivative Securitites Beneficially Owned | - -----------------------------------------------------------------------------------------------------------------------------------| 1.Title of Derivative |2.Date Exer- |3.Title and Amount | |4. Conver-|5. Owner- |6. Nature of Indirect | Security | cisable and | of Underlying | |sion or |ship | Beneficial Ownership | | Expiration | Securities | |exercise |Form of | | | Date(Month/ |-----------------------|---------|price of |Deriv- | | | Day/Year) | |Amount |deri- |ative | | | Date | Expira- | |or |vative |Security: | | | Exer- | tion | Title |Number of|Security |Direct(D) or | | | cisable | Date | |Shares | |Indirect(I) | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| Employee Stock Option | | | | | | | | (right to buy) | (1) |10/27/09 | Common Stock | 7,000 | $13.00 | D | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------|
Explanation of Responses: (1) The option became and will become exercisable in five equal annual installments beginning on October 27, 2000. /s/ Mark J. Goldberg ------------------------ ** Mark J. Goldberg May 14, 2001 ------------------------ 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 provided is insufficient, see Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 of 2 -----END PRIVACY-ENHANCED MESSAGE-----