-----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, EExUZCPZDkq7J5YJzHRc2lVcKP5eWBGM7IO5ANgof0H9dO/Hi52VNrrOwOzpg86h UH3kYSNfGd5ZPkM/L2CiUA== 0000935836-99-000139.txt : 19990412 0000935836-99-000139.hdr.sgml : 19990412 ACCESSION NUMBER: 0000935836-99-000139 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19980701 FILED AS OF DATE: 19990409 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OMNIS TECHNOLOGY CORP CENTRAL INDEX KEY: 0000820738 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 943046892 STATE OF INCORPORATION: DE FISCAL YEAR END: 0331 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-16449 FILM NUMBER: 99590501 BUSINESS ADDRESS: STREET 1: 981 INDUSTRIAL WAY STREET 2: BUILDING B CITY: SAN CARLOS STATE: CA ZIP: 94070-4117 BUSINESS PHONE: 6506327100 MAIL ADDRESS: STREET 1: 989 E HILLSDALE BLVD. #400 CITY: FOSTER CITY STATE: CA ZIP: 94404 FORMER COMPANY: FORMER CONFORMED NAME: BLYTH HOLDINGS INC DATE OF NAME CHANGE: 19920703 COMPANY DATA: COMPANY CONFORMED NAME: WAGNER GEOFFREY P CENTRAL INDEX KEY: 0001083444 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 6600 S W 92ND AVENUE STREET 2: SUITE 370 CITY: PORTLAND STATE: OR ZIP: 97233 BUSINESS PHONE: 5037684908 5 1 OMB Number 3235-0362 Expires: September 30, 1998 Estimated average burden hours per response 1.0 FORM 5 / / Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). /X/ Form 3 Holdings Reported / / Form 4 Holdings Reported U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D. C. 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 (Print or Type Responses) 1. Name and Address of Reporting Person* <> (Last) (First) (Middle), (Street), (City) (State) (Zip) 2. Issuer Name and Ticker or Trading Symbol <> 3. IRS or Social Security Number of Reporting Person (Voluntary) ______ 4. Statement for Month/Year <<7/98>> 5. If Amendment, Date of Original (Month/Year) ___________ 6. Relationship of reporting person to issuer (Check all applicable) <> Director ____ 10% Owner ____ Officer (give ____ Other (specify title below) below) ______________________ 7. Individual or Joint/Group Filing (Check Applicable line) <> Form filed by one Reporting Person ____ Form filed by More than One Reporting Person SEC 2270 (9-96) Page 1 of 4 FORM 5 (continued) Page 2 of 4 Pages Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Security (Instr. 3) ________________________________________ 2. Transaction Date (Month/Day/Year) _______________ 3. Transaction Code (Instr. 8) ______________ 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) Amount <<0>> (A) or (D) _______ Price ____________ 5. Amount of Securities Beneficially Owned at End of Issuer's Fiscal Year (Inst. 3 and 4) <<0>> 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) ______________ 7. Nature of Indirect Beneficial Ownership (Inst. 4) _____________________________________________________________________ __________________________________________________________________________ * If the form is filed by more than one reporting person, see Instruction 4(b)(v). SEC 1474 (7-96) FORM 5 (continued) Page 3 of 4 Pages Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1. Title of Derivative Security (Instr. 3) _____________________________ 2. Conversion or Exercise Price of Derivative Security _______________ 3. Transaction Date (Month/Day/Year) ______________ 4. Transaction Code (Instr. 8) __________________ 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) (A) _____________ (D) ______________ 6. Date Exercisable and Expiration Date (Month/Day/Year) Date Exercisable Expiration Date ____________________ ________________________ 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) Title ______________________ Amount or Number of Shares ________ 8. Price of Derivative Security (Instr. 5) _______________ 9. Number of Derivative Securities Beneficially Owned at End of Year (Instr. 4) _______________ 10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) __________________ 11. Nature of Indirect Beneficial Ownership (Inst. 4) _____________________________________________________________________ __________________________________________________________________________ FORM 5 (continued) Page 4 of 4 Pages Explanation of Responses: /s/ Geoffrey P. Wagner 4/9/99 Geoffrey P. Wagner 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 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. SEC 2270 (9-96) 4410/001/1039320 -----END PRIVACY-ENHANCED MESSAGE-----