FORM 3 |
UNITED STATES 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 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/01/2005 |
3. Issuer Name and Ticker or Trading Symbol
NATIONAL LAMPOON INC [ NLPN ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock | 3,000 | D | |
Series B Convertible Preferred Stock | 426(1) | D | |
Series C Convertible Preferred Stock | 1,090(2) | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Warrant to Purchase Series B Convertible Preferred Stock | 08/27/2002 | 05/16/2007 | Series B Convertible Preferred Stock(3) | 426 | $1.775 | D | |
Common Stock Purchase Warrant | 12/09/2004 | 12/09/2008 | Common Stock | 10,900 | $1.77 | D | |
Option to Purchase Common Stock(4) | 08/07/2002(5) | 08/22/2009 | Common Stock | 10,000 | $2.75 | D | |
Option to Purchase Common Stock(6) | 10/14/2002(7) | 10/14/2009 | Common Stock | 270,000 | $3 | D | |
Option to Purchase Common Stock(8) | 06/30/2003(9) | 06/30/2010 | Common Stock | 100,000 | $2.25 | D | |
Option to Purchase Common Stock(10) | 06/17/2004(11) | 06/17/2011 | Common Stock | 100,000 | $1.6 | D | |
Option to Purchase Common Stock(12) | 06/17/2004(13) | 06/17/2011 | Common Stock | 200,000 | $1.6 | D |
Explanation of Responses: |
1. The 426 shares of Series B Convertible Preferred Stock may be converted by Mr. Bennett into 24,000 shares of Common Stock. |
2. The 1,090 shares of Series C Convertible Preferred Stock may be converted by Mr. Bennett into 21,800 shares of Common Stock. |
3. The 426 shares of Series B Convertible Preferred Stock may be converted by Mr. Bennett into 24,000 shares of Common Stock. |
4. This option was granted from the J2 Communications Amended and Restated 1999 Stock Option, Restricted Stock and Deferred Stock Plan, which is an equity incentive plan adopted by the Company for the benefit of its employees, officers, directors, consultants and agents. |
5. This option is exercisable in equal increments over a 24 month period. |
6. This option was granted from the J2 Communications Amended and Restated 1999 Stock Option, Restricted Stock and Deferred Stock Plan. |
7. This option is exercisable in equal increments over a 36 month period. |
8. This option was granted from the J2 Communications 1999 Amended and Restated Stock Option, Restricted Stock and Deferred Stock Plan. |
9. This option is exercisable in equal increments over a 36 month period. |
10. This option was granted from the J2 Communications Amended and Restated 1999 Stock Option, Restricted Stock and Deferred Stock Plan. |
11. The right to purchase 16,666 shares of Common Stock vested on the date of grant. The right to purchase the remaining shares vests in equal increments over 30 months. |
12. This option was granted from the J2 Communications Amended and Restated 1999 Stock Option, Restricted Stock and Deferred Stock Plan. |
13. This option is exercisable in equal increments over a 36 month period. |
Remarks: |
All shares of Common Stock referred to in this report are adjusted to reflect the 2 for 1 stock split that was effective on September 15, 2004. |
Douglas S. Bennett | 02/07/2005 | |
** Signature of Reporting Person | Date | |
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 5 (b)(v). | ||
** 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 is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |