4 1 form4brennan080802.txt FORM 4 FOR BERNARD BRENNAN FOR JULY 2002 ---------- FORM 4 ---------- [ ] Check this box if no longer -------------------------- subject to Section 16. Form 4 OMB APPROVAL or Form 5 obligations may -------------------------- continue. See Instruction 1(b). OMB Number: 3235-0287 Expires: December 31, 2001 Estimated average burden hours per respsonse.....0.5 -------------------------- U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 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(f) of the Investment Company Act of 1940 ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker Trading Symbol 6. Relationship of Reporting Person(s) to Issuer Park City Group, Inc. - PKCY (Check all applicable) Brennan Bernard F. [X] Director [ ] 10% Owner ----------------------------------------------------------------------------------------------- [ ] Officer(give [ ] Other (specify (Last) (First) (Middle) 3. IRS Identification 4. Statement for Month/Year title below below) Number of Reporting 959 Ponte Vedra Blvd. Person, if an entity July 2002 ------------------------------ ------------------------------------------ (voluntary) ---------------------------- ------------------------------------ (Street) 5. If Amendment, Date 7.Individual or Joint/Group of Original Filing (Check Applicable Line) Ponte Vedra Beach, FL 32082 (Month/Year) [X] Form filed by One Reporting -------------------------------------------- Person (City) (State) (Zip) [ ] Form filed by More than One Reporting Person ----------------------------------------------------------------------------------------------------------------------------------- TABLE 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ----------------------------------------------------------------------------------------------------------------------------------- 1. Title of Security 2. Trans- 3. Transaction 4. Securities Acquired(A) 5. Amount of 6.Owner- 7. Nature of (Instr. 3) action Code or Disposed of (D) Securities ship Indirect Date (Instr.8) (Instr. 3,4 and 5) Beneficially Form: Beneficial (Month/ -------------- ------------------------- Owned at End Direct (D) Ownership Day/ Amount (A) or Price of Month or Indirect (Instr.4) Year) Code V (D) (Instr. 3 and 4) (I) (Instr.4) ----------------------------------------------------------------------------------------------------------------------------------- 2,000,000 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ 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 on 4(b)(v).
FORM 4 (CONTINUED) Table II -- Derivative Securities Acquired, Disposed of, or Benficially Owned (e.g., puts, calls, warrants, options, convertible securities) ----------------------------------------------------------------------------------------------------------------------------------- 1.Title of 2.Conver- 3.Trans- 4.Tansac- 5.Number of 6.Date Exercis- 7.Title and 8.Price 9.Number 10.Owner- 11.Nature Derivative sion or action tion Derivative able and Amount of of of Deri- ship of In- Security Exercise Date Code Securities Expiration Underlying Deri- vative Form of direct (Instr.3) Price of (Month/ (Instr.8) Acquired Date Securities vative Secur- Deriva- Bene- Deri- Day/ (A) or (Month/Day/ (Intr. 3 Secu- ities tive ficial vative Year) Disposed Year) and 4) rity Benefi- Security: Owner- Security of (D) ----------------- ------------- (Instr. cially Direct ship (Instr.3, Amount 5) Owned (D) or (Instr. 4 and 5) or at End Indirect 4) Date Expir- Title Number of (I) Exer- ation of Month (Instr.4) Code V (A) (D) cisable Date Shares (Instr.4) ------------------------------------------------------------------------------------------------------------------------------------ Option $0.08 7/9/02 A 125,000 7/1/03 7/8/07 Common 125,000 $0.08 2,916,667 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: /s/ Bernard F. Brennan (1) 8/8/02 -------------------------------- -------- Signature of Reporting Person Date (1) 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.