-----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, A2grNfCs11E++mWC3PtC16jn36vYA0EDjAgmWAZ1GMSb/diuxMbcFLOV2Ty8d4OX jAuD67NbFfhy+m0xS6bIsA== 0001088127-99-000014.txt : 19990615 0001088127-99-000014.hdr.sgml : 19990615 ACCESSION NUMBER: 0001088127-99-000014 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19990517 FILED AS OF DATE: 19990610 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PENTECH INTERNATIONAL INC CENTRAL INDEX KEY: 0000760461 STANDARD INDUSTRIAL CLASSIFICATION: PENS, PENCILS & OTHER ARTISTS' MATERIALS [3950] IRS NUMBER: 232259391 STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-15374 FILM NUMBER: 99644130 BUSINESS ADDRESS: STREET 1: 195 CARTER DRIVE CITY: EDISON STATE: NJ ZIP: 08817 BUSINESS PHONE: 9082876640 MAIL ADDRESS: STREET 2: 195 CARTER DR CITY: EDISON STATE: NJ ZIP: 08817 COMPANY DATA: COMPANY CONFORMED NAME: KUYPERS JERRY CENTRAL INDEX KEY: 0001088136 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 5555 ODANA RD SUITE 205 CITY: MADISON STATE: WI ZIP: 53719 MAIL ADDRESS: STREET 1: 5555 ODANA RD SUITE 205 CITY: MADISON STATE: WI ZIP: 53719 4 1 FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 1. Name and Address of Reporting Person: Kuypers Jerry (Last) (First) 5555 Odana Road Madison WI 53719 (Street) (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol: Pentech International Inc./PNTK 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Statement for Month/Year: May/1999 5. If Amendment, Date of Original (Month/Year): 6. Relationship of Reporting Person to Issuer (Check all applicable): Director 10% Owner X Officer (give title below) Other (Specified below) Vice - President - Sales Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned: 1. Title of Security: 2. Transaction Date: (Month/Day/Year) 3. Transaction Code: Code V 4. Securities Acquired (A) or Disposed of (D): Amount (A) or (D) Price 5. Amount of Securities Beneficially Owned at End of Month: 6. Ownership Form-Direct (D) or Indirect (I): 7. Nature of Indirect Beneficial Ownership: Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities): 1. Title of Derivative Security: Common Stock 2. Conversion or Exercise Price of Derivative Security: $.875 3. Transaction Date (Month/Day/Year): 5/17/99 4. Transaction Code: Code V A 5. Number of Derivative Securities Acquired (A) or Disposed of (D): 45,000 (A) 6. Date Exercisable and Expiration Date (Month/Day/Year): 03/03/00 03/03/03 (Date Exercisable) (Expiration Date) 7. Title and Amount of Underlying Securities: Common Stock 45,000 (Title) (Amount of Number of Shares) 8. Price of Derivative Security: 9. Number of Derivative Securities Beneficially Owned at End of Month: 90,000 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I): D 11. Nature of Indirect Beneficial Ownership: Explanation of Responses: s/Jerry Kuypers 6/8/99 Signature of Reporting Person Date -----END PRIVACY-ENHANCED MESSAGE-----