-----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, LaeDjCiVjqf1C4nAkD1mwgbJKE5rEtT8xV4GagVTxRM12S2YAl0qy6XmUOcJ8/8w XQ2gv4JYSgB/L67xHyaHjw== 0000950123-01-001366.txt : 20010223 0000950123-01-001366.hdr.sgml : 20010223 ACCESSION NUMBER: 0000950123-01-001366 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20010214 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PORTA SYSTEMS CORP CENTRAL INDEX KEY: 0000079564 STANDARD INDUSTRIAL CLASSIFICATION: TELEPHONE & TELEGRAPH APPARATUS [3661] IRS NUMBER: 112203988 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 001-08191 FILM NUMBER: 1543221 BUSINESS ADDRESS: STREET 1: 575 UNDERHILL BLVD CITY: SYOSSET STATE: NY ZIP: 11791 BUSINESS PHONE: 5163649300 MAIL ADDRESS: STREET 1: 575 UNDERHILL BLVD CITY: SYOSSET STATE: NY ZIP: 11791 COMPANY DATA: COMPANY CONFORMED NAME: MILLER LLOYD I III CENTRAL INDEX KEY: 0000949119 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 4650 GORDON DRIVE CITY: NAPLES STATE: FL ZIP: 33940 BUSINESS PHONE: 9412628577 5 1 y45481ie5.txt FORM 5 1 - -------------- ---------------------------------- FORM 5 OMB APPROVAL - -------------- ---------------------------------- OMB Number 3235-0362 [x] Check box if no longer subject to Expires: December 31, 2001 Section 16. Form 4 or Form 5 Estimated average burden obligations may continue. See hours per response.............1.0 Instruction 1(b). ---------------------------------- [ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 ANNUAL 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* Miller, III Lloyd I - -------------------------------------------------------------------------------- (Last) (First) (Middle) 4550 Gordon Drive - -------------------------------------------------------------------------------- (Street) Naples FL 34102 - -------------------------------------------------------------------------------- (City) (State) (Zip) ________________________________________________________________________________ 2. Issuer Name AND Ticker or Trading Symbol Porta Systems Corporation (PSI) ________________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person (Voluntary) ###-##-#### ________________________________________________________________________________ 4. Statement for Month/Year December, 2000 ________________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) ________________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [x] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ________________________________________________________________________________ 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 ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED ================================================================================
5. 6. 4. Amount of Owner- Securities Acquired (A) or Securities ship Disposed of (D) Beneficially Form: 7. 2. (Instr. 3, 4 and 5) Owned at end Direct Nature of Transaction 3. ----------------------------- of Issuer's (D) or Indirect 1. Date Transaction (A) Fiscal Year Indirect Beneficial Title of Security (Month/Day/ Code Amount or Price (Instr. 3 (I) Ownership (Instr. 3) Year) (Instr. 8) (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the form is filed by more than one reporting person, see instruction 4(b)(v). (Over) SEC 2270(7/96) Page 1 of 3 2 FORM 5 (continued) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Non-Qualified $2.03 5/1/00 Common 5,000(1) 5,000 D Stock Option Stock - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 6,250(2) 6,250 I By Trust Warrants Stock A-2 - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 6,250(2) 6,250 I By Keogh Warrants Stock - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 1,250(2) 1,250 I Trust Warrants Stock f/b/o Kimberly I. Miller - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 1,250(2) 1,250 I Trust Warrants Stock f/b/o Catherine Miller - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== EXPLANATION OF RESPONSES: - ------------------------------------------------------------------------------------------------------------------------------------
(1) These options are granted pursuant to the Company's 1996 Long-Term Incentive Plan, a 16b-3 plan, and are exercisable in installments. (2) The reporting person disclaims beneficial ownership in these securities except to the extent of his beneficial ownership therein. /s/ Lloyd I. Miller, III 2/13/01 - --------------------------------------------- ----------------------- **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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2 SEC 2270 (7-96) Page 2 of 3 3 FORM 5 (continued) TABLE II -- DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature or Derivative 6. of Underlying 8. ities Secur- of Exer- Securities Date Securities Price Bene- ity: In- cise 3. Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date action (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 1,250(2) 1,250 I UGMA Warrants Stock Alexandra Miller - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 1,250(2) 1,250 I Trust Warrants Stock Lloyd I. Miller GST - ------------------------------------------------------------------------------------------------------------------------------------ Series D $3.00 4/10/00 Common 1,250(2) 1,250 I UGMA Warrants Stock Lloyd I. Miller IV - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
EXPLANATION OF RESPONSES: (1) These options are granted pursuant to the Company's 1996 Long-Term Incentive Plan, a 16b-3 plan, and are exercisable in installments. (2) The reporting person disclaims beneficial ownership in these securities except to the extent of his beneficial ownership therein. Page 3 of 3 -----END PRIVACY-ENHANCED MESSAGE-----