-----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, NECadNooTi8KjPVI57i1k25JyvQBvqMA3vKi3mgI3twesbRXJJWjvC1UxBdIuLYH HodOmzHCkhNDEbDVseZFwg== 0000906504-96-000064.txt : 19961023 0000906504-96-000064.hdr.sgml : 19961023 ACCESSION NUMBER: 0000906504-96-000064 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19961022 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GEORGIA BONDED FIBERS INC CENTRAL INDEX KEY: 0000041052 STANDARD INDUSTRIAL CLASSIFICATION: CONVERTED PAPER & PAPERBOARD PRODS (NO CONTAINERS/BOXES) [2670] IRS NUMBER: 221427551 STATE OF INCORPORATION: NJ FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-36273 FILM NUMBER: 96646136 BUSINESS ADDRESS: STREET 1: ONE BONTEX DR CITY: BUENA VISTA STATE: VA ZIP: 24416 BUSINESS PHONE: 7032612181 MAIL ADDRESS: STREET 1: PO BOX 751 CITY: BUENA VISTA STATE: VA ZIP: 24416 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: KOSTELNI DOLORES CENTRAL INDEX KEY: 0001017428 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13D/A BUSINESS ADDRESS: STREET 1: ROUTE 4 BOX251 CITY: LEXINGTON STATE: VA ZIP: 24450 BUSINESS PHONE: 5402612304 MAIL ADDRESS: STREET 1: ROUTE 4 BOX 251 CITY: LEXINGTON STATE: VA ZIP: 24450 SC 13D/A 1 AMENDMENT NO. 1 TO SCHEDULE 13D UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ------------------------ SCHEDULE 13D (Amendment No. 1) Under THE SECURITIES EXCHANGE ACT OF 1934 ------------------------ GEORGIA BONDED FIBERS, INC. (Name of Issuer) COMMON STOCK, $.10 PAR VALUE (Title of Class of Securities) 373136209 (CUSIP Number) ------------------------ James C. Kostelni, Chairman and President Georgia Bonded Fibers, Inc. One Bontex Drive Buena Vista, VA 24416-0751 (703) 261-2181 (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) ------------------------ October 14, 1996 (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(b)(3) or (4), check the following box [ ]. Check the following box if a fee is being paid with the statement [ ]. (A fee is not required only if the reporting person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7.) The information required on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act. CUSIP No. 373136209 - ---------------------------------------------------------------------------- (1) Name of Reporting Person. S.S. or I.R.S. Identification Nos. of Above Person Dolores Kostelni SS# ###-##-#### - ---------------------------------------------------------------------------- (2) Check the Appropriate Box if a Member (a) [ ] of a Group (See Instructions) (b) [X] - ---------------------------------------------------------------------------- (3) SEC Use Only - ---------------------------------------------------------------------------- (4) Source of Funds (See Instructions) PF - ---------------------------------------------------------------------------- (5) Check if Disclosure of Legal Proceedings [ ] is Required Pursuant to Items 2(d) or 2(e) - ---------------------------------------------------------------------------- (6) Citizenship or Place of Organization United States - ---------------------------------------------------------------------------- Number of Shares (7) Sole Voting Beneficially Owned Power 19,700 shares by Each Reporting ------------------------------------------------- Person With (8) Shared Voting Power 675,507 shares ------------------------------------------------- (9) Sole Dispositive Power 19,700 shares ------------------------------------------------- (10) Shared Dispositive Power 675,507 shares - ---------------------------------------------------------------------------- (11) Aggregate Amount Beneficially Owned by Each Reporting Person 695,207 shares - ---------------------------------------------------------------------------- (12) Check if the Aggregate Amount in Row [ ] (11) Excludes Certain Shares (See Instructions) - ---------------------------------------------------------------------------- (13) Percent of Class Represented by Amount in Row (11) 44.2% - ---------------------------------------------------------------------------- (14) Type of Reporting Person (See Instructions) IN - ---------------------------------------------------------------------------- ITEM 1. Security and Issuer The class of securities to which this statement relates is Common Stock, $.10 par value, of Georgia Bonded Fibers, Inc. ("BONTEX"), a New Jersey corporation. The address of BONTEX's principal executive offices is 15 Nuttman Street, Newark, New Jersey 07013-3508. ITEM 2. Identity and Background This statement is being filed by Dolores Kostelni. Mrs. Kostelni's occupation is as a cook book author and food writer, and her residence address is Rt. 4, Box 251, Turtle Brooke Lane, Lexington, Virginia 24450. Mrs. Kostelni is a citizen of the United States. Mrs. Kostelni has not, during the last five years, been convicted in a criminal proceeding (excluding traffic violations or similar misdemeanors). Further, Mrs. Kostelni has not, during the last five years, been a party to a civil proceeding of a judicial or administrative body of competent jurisdiction which resulted in Mrs. Kostelni being subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities laws or finding any violation with respect to such laws. ITEM 3. Source and Amount of Funds or Other Consideration This amendment is being filed to report Mrs. Kostelni's purchase of 11,200 shares of BONTEX common stock. Such purchase was made with personal funds in the amount of $39,200 ($3.50 per share). No part of the funds used to purchase the securities was obtained by loan. Mrs. Kostelni previously reported her acquisition of beneficial ownership of 675,507 shares of BONTEX common stock, as a result of her appointment and qualification as an executor of the estate of Marie G. Surmonte (the "Estate"). ITEM 4. Purpose of Transaction The purchase of the 11,200 shares was made for investment purposes. Mrs. Kostelni is the daughter of the founder of BONTEX and the spouse of BONTEX's President and Chief Executive Officer. ITEM 5. Interest in Securities of the Issuer (a) Mrs. Kostelni is the beneficial owner of 695,207 shares of BONTEX common stock, which represent approximately 44.2% of BONTEX's issued and outstanding common stock. As previously reported, Mrs. Kostelni beneficially owns 675,507 shares of BONTEX common stock as an executor of the Estate. Patricia M. Tischio, an individual, 6 Stonecrop Road, Norwalk, Connecticut 06851, and First Union National Bank, a national banking association organized under the laws of the United States, 303 Broad Street, Red Bank, New Jersey 07701, also are executors of the Estate and have a beneficial ownership interest in those 675,507 shares. (b) Mrs. Kostelni has sole voting power and sole dispositive power with respect to 19,700 shares of the BONTEX common stock of which she is the beneficial owner. Mrs. Kostelni, Mrs. Tischio and First Union National Bank have shared voting power and shared dispositive power with respect to the 675,507 shares of BONTEX common stock which they hold as executors of the Estate. (c) Mrs. Kostelni has not had any transactions in BONTEX common stock during the past sixty days, except as described above. (d) Not applicable. (e) Not applicable. ITEM 6. Contracts, Arrangements, Understandings or Relationships With Respect to Securities of the Issuer None. ITEM 7. Material to Be Filed as Exhibits None. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. October 21, 1996 -------------------------------------- (Date) s/Dolores Kostelni ------------------------------------- Dolores Kostelni -----END PRIVACY-ENHANCED MESSAGE-----