-----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, FCWLf66gfkZe6vRCUdE3afCqK662/AYpvjLZJDYicEqsnvZR2y85u3xsGUa5x1yL vnOiQ0OgfRAE3mCvZo/Lvw== 0001088127-99-000016.txt : 19990615 0001088127-99-000016.hdr.sgml : 19990615 ACCESSION NUMBER: 0001088127-99-000016 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: 99644350 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 3 U.S. 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 1. Name and Address of Reporting Person: Kuypers Jerry (Last) (First) (Middle) 5555 Odana Road Madison WI 53719 (Street) (City) (State) (Zip) 2. Date of Event Requiring Statement: 04/21/99 (Month/Day/Year) 3. IRS or Social Security Number of Reporting Person (Voluntary): 4. Issuer Name and Ticker or Trading Symbol: Pentech International Inc. /PNTK 5. Relationship of Reporting Person to Issuer (Check all applicable): Director 10% Owner X Officer (give title below) Other (Specify below) Vice President, Sales Table I - Non-Derivative Securities Beneficially Owned: 1. Title of Security: 2. Amount of Securities Beneficially Owned: 3. Ownership Form-Direct (D) or Indirect (I): 4. Nature of Indirect Beneficial Ownership: Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities): 1. Title of Derivative Security: Common Stock Common Stock 2. Date Exercisable and Expiration Date (Month/Day/Year): 11/26/97 11/26/00 (Date Exercisable) (Expiration Date) 8/5/99 8/5/03 (Date Exercisable) (Expiration Date) 3. Title and Amount of Securities Underlying Derivative Security: Common Stock 15,000 (Title) (Amount or Number of Shares) Common Stock 30,000 (Title) (Amount or Number of Shares) 4. Conversion or Exercise Price of Derivative Security: .75 1.50 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I): D D 6. Nature of Indirect Beneficial Ownership: Explanation of Responses: s/Jerry Kuypers 6/8/99 Signature of Reporting Person Date N:\ANNE\MISC\FORM-3.JK -----END PRIVACY-ENHANCED MESSAGE-----