-----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, DouWiXx2Ov6IqruIk83lxAlLgPPuEsvD4NhjYTpDnL6dZ9pthwlI6FnPnf6/+Eok ktEXWmTcQGnOHP/idUU/sg== 0001011438-02-000162.txt : 20020414 0001011438-02-000162.hdr.sgml : 20020414 ACCESSION NUMBER: 0001011438-02-000162 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011001 FILED AS OF DATE: 20020221 COMPANY DATA: COMPANY CONFORMED NAME: TIZABI JACQUES CENTRAL INDEX KEY: 0001165319 DIRECTOR FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: 9300 WILSHIRE BLVD STREET 2: SUITE 308 CITY: BEVERLY HILLS STATE: CA ZIP: 90212 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: POLLUTION RESEARCH & CONTROL CORP /CA/ CENTRAL INDEX KEY: 0000763950 STANDARD INDUSTRIAL CLASSIFICATION: INDUSTRIAL INSTRUMENTS FOR MEASUREMENT, DISPLAY, AND CONTROL [3823] IRS NUMBER: 952746949 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A SEC ACT: 1934 Act SEC FILE NUMBER: 001-09327 FILM NUMBER: 02555196 BUSINESS ADDRESS: STREET 1: 506 PAULA AVE CITY: GLENDALE STATE: CA ZIP: 91201 BUSINESS PHONE: 8182477601 MAIL ADDRESS: STREET 1: 506 PAULA AVE CITY: GLENDALE STATE: CA ZIP: 91201 FORMER COMPANY: FORMER CONFORMED NAME: DASIBI ENVIRONMENTAL CORP DATE OF NAME CHANGE: 19900529 3/A 1 form3-a_tizabi.txt U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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* TIZABI JACQUES - -------------------------------------------------------------------------------- (Last) (First) (Middle) C/O POLLUTION RESEARCH AND CONTROL CORP. 9300 WILSHIRE BLVD., SUITE 308 - -------------------------------------------------------------------------------- (Street) BEVERLY HILLS CA 90212 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Date of Event Requiring Statement (Month/Day/Year) 10/01/01 ________________________________________________________________________________ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ________________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol POLLUTION RESEARCH AND CONTROL CORP. (NASDAQ-SC: PRCC) ________________________________________________________________________________ 5. Relationship of Reporting Person to Issuer (Check all applicable) [X] Director [_] 10% Owner [X] Officer (give title below) [_] Other (specify below) PRESIDENT AND CHIEF EXECUTIVE OFFICER ________________________________________________________________________________ 6. If Amendment, Date of Original (Month/Day/Year) 2/11/02 ________________________________________________________________________________ 7. Individual or Joint/Group Filing (Check applicable line) [X] Form Filed by One Reporting Person [_] Form Filed by More than One Reporting Person ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK 1,800 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print of Type Responses) (Over) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Derivative Exer- tion of Derivative (I) Ownership Security (Instr. 4) cisable Date Title Shares Security (Instr. 5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK WARRANTS IMMED. (1) COMMON STOCK 189,900 (1) I BY ASTOR (RIGHT TO BUY) CAPITAL, INC. - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK WARRANTS IMMED. 7/17/05 COMMON STOCK 6,000 $2.29 I BY JRT (RIGHT TO BUY) HOLDINGS, INC. - ------------------------------------------------------------------------------------------------------------------------------------ 9% CONVERTIBLE IMMED. (2) COMMON STOCK $20,000 (2) I BY JRT DEBENTURES HOLDINGS, INC. ====================================================================================================================================
Explanation of Responses: (1) Represents: 30,000 common stock warrants expiring on 6/1/02 at an exercise price of $1.50 per share; 18,000 common stock warrants expiring on 9/1/02 at an exercise price of $2.25 per share; 20,000 common stock warrants expiring on 2/23/03 at an exercise price of $2.25 per share; 100,000 common stock warrants expiring on 6/6/03 at an exercise price of $5.00 per share; and 21,900 common stock warrants expiring on 7/17/05 at an exercise price of $2.29 per share. (2) Conversion price is the lesser of (i) $2.10 or (ii) 80% of the lowest closing bid price of the common stock for the five trading days immediately preceding the date of conversion. The debenture may be converted until such time as the principal amounts and interest are paid off. /S/ JACQUES TIZABI FEBRUARY 20, 2002 - --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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. (Print or Type Responses) Page 2 -----END PRIVACY-ENHANCED MESSAGE-----