-----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, Rw/wZRS4orAQphK3NXJcvtSOq/E5h4Hl2wH9zXuZiVTxceJYtC6CLc8QPKARD7D/ Oh0PjDEIj4UAgyOz6+YVhg== 0000950112-96-001439.txt : 19960514 0000950112-96-001439.hdr.sgml : 19960514 ACCESSION NUMBER: 0000950112-96-001439 CONFORMED SUBMISSION TYPE: 10-C PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19960507 FILED AS OF DATE: 19960513 SROS: NASD FILER: COMPANY DATA: COMPANY CONFORMED NAME: FORWARD INDUSTRIES INC CENTRAL INDEX KEY: 0000038264 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS PRODUCTS, NEC [3089] IRS NUMBER: 131950672 STATE OF INCORPORATION: NY FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 10-C SEC ACT: 1934 Act SEC FILE NUMBER: 000-06669 FILM NUMBER: 96561081 BUSINESS ADDRESS: STREET 1: 702 SOUTH CHAPIN STREET 2: P O BOX 1277 CITY: SOUTH BEND STATE: IN ZIP: 46624 BUSINESS PHONE: 5165641100 MAIL ADDRESS: STREET 1: 275 HEMPSTEAD TURNPIKE CITY: WEST HEMPSTEAD STATE: NY ZIP: 11552 10-C 1 FORWARD INDUSTRIES, INC. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. FORM 10-C REPORT BY ISSUER OF SECURITIES QUOTED ON NASDAQ INTERDEALER QUOTATION SYSTEM FILED PURSUANT TO SECTION 13 OR 15(d) OF THE SECURITIES EXCHANGE ACT OF 1934 AND RULE 13A-17 OR 15d-17 THEREUNDER FORWARD INDUSTRIES, INC. - -------------------------------------------------------------------------------- (Exact name of issuer as specified in charter) 275 Hempstead Turnpike, West Hempstead, NY 11552 - -------------------------------------------------------------------------------- (Address of principal executive offices) Issuer's telephone number, including area code (516) 564-1100 --------------------------------- I. CHANGE IN NUMBER OF SHARES OUTSTANDING Indicate any change (increase or decrease) of five percent or more in the number of shares outstanding: 1. Title of security Common Stock, par value $.01 --------------------------------------------------------- 2. Number of shares outstanding before the change 4,643,282 ---------------------------- 3. Number of shares outstanding after the change 4,891,282 ----------------------------- 4. Effective date of change May 7, 1996 -------------------------------------------------- 5. Method of change: Specify method (such as merger, acquisition, exchange, distribution, stock split, reverse split, acquisition of stock for treasury, etc.) Warrant exercises - -------------------------------------------------------------------------------- Give brief description of transaction Exercise of Class A Warrants (25,000 ------------------------------------- shares) and Class B Warrants (223,000 shares) to purchase shares of Common Stock - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- II. CHANGE IN NAME OF ISSUER 1. Name prior to change ------------------------------------------------------ 2. Name after change --------------------------------------------------------- 3. Effective date of charter amendment changing name ------------------------- 4. Date of shareholder approval of change, if required ----------------------- Date May 10, 1996 Theodore H. Schiffman ---------------------------- --------------------------------------- Theodore H. Schiffman Chairman and Chief Executive Officer -----END PRIVACY-ENHANCED MESSAGE-----