-----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, OVyNsvWuABZB0wpJZzZ2g5EI/vU9X5kJWg0Udm1VpgIsDLK3GokYGqduOAoo/WUa HvBhOkd0zBEXjZoUD5/RCQ== 0001001277-02-000268.txt : 20020524 0001001277-02-000268.hdr.sgml : 20020524 20020524170107 ACCESSION NUMBER: 0001001277-02-000268 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20020430 FILED AS OF DATE: 20020524 COMPANY DATA: COMPANY CONFORMED NAME: APATOFF MICHAEL CENTRAL INDEX KEY: 0001168959 DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 11 EDWRDS AVENUE CITY: SAUSALITO STATE: CA ZIP: 94965 MAIL ADDRESS: STREET 1: 11 EDWARDS AVENUE CITY: SUSALITO STATE: CA ZIP: 94965 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: DBS INDUSTRIES INC CENTRAL INDEX KEY: 0000857502 STANDARD INDUSTRIAL CLASSIFICATION: TELEGRAPH & OTHER MESSAGE COMMUNICATIONS [4822] IRS NUMBER: 841124675 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-28348 FILM NUMBER: 02662637 BUSINESS ADDRESS: STREET 1: 100 SHORELINE HWY STREET 2: STE 100 CITY: MILL VALLEY STATE: CA ZIP: 94941 BUSINESS PHONE: 4153808055 4 1 form4apatofffor402.txt APATOFF402 FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP | | Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). 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*/ 2. Issuer Name and Ticker / 6. Relationship of Reporting Person(s) to Issuer / or Trading Symbol / (Check all applicable) / / / / X Director X 10% Owner / / ___ Officer ___ Other / / (give title below) (specify below) / / Apatoff, Michael / DBS Industries, Inc. ("DBSS") / - ----------------------------------------/----------------------------------------/-------------------------------------------------- (Last) (First) (Middle) / 3. IRS or / 4. Statement for / 7. Individual or Joint/Group Filing / Social Security / (Month/Year) / (Check Applicable Line) c/o DBS Industries, Inc. / Number of / / 100 Shoreline Highway, Suite 190A / Reporting Person / 4/02 / X Form filed by one Reporting Person - ----------------------------------------/ /------------------/ (Street) / / 5. If Amendment, / ___ Form filed by more than One / / Date of / Reporting Person / / Original / Mill Valley CA 94941 / / (Month/Year) / - --------------------------------------- / / / (City) (State) (Zip) / / / - -----------------------------------------------------------------------------------------------------------------------------------
TABLE I - NONDERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title /2.Trans- /3.Transaction / 4. Securities Acquired (A) / 5. Amount of /6. Ownership / 7. Nature of of / action / Code / or Disposed of (D) / Securities / Form: / Indirect Security / Date / (Instr. 8) / (Instr. 3,4 and 5) / Beneficially / Direct (D) / Beneficial (Inst.3) /(Mo/Day/Yr) /-------------------------------------------------/ Owned at End / or / Ownership / / Code / V / Amount /(A) or (D)/ Price / of Month / Indirect(I) / (Instr.4) / / / / / / / (Inst. 3 and 4) / (Instr.4) / ==================================================================================================================================== Common Stock 5/15/02 M 1,100,000 A $0.10 4,778,371 D N/A - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== 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 4(b)(v).
2 FORM 4 (continued) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ 1. / 2. /3. /4. /5. /6. /7. /8. /9. /10. / 11. Title of / Con- / Trans- / Trans- / Number of / Date / Title and / Price / Number / Owner- / Nature Derivative / version / action / action / Derivative / Exercisable / Amount of / of / of / ship / of Security / or / Date / Code / Securities / and / Underlying / Deriv- / Deriv- / form of/ Indirect (Instr. 3) / exercise/ (Mo. /(Inst.8)/ Acquired / Expiration / Securities / ative / ative / Deriv- / Beneficial / Price of/ Day / / (A) or / Date / (Instr. 3,4) / Secu- / Secu- / ative / Ownership / of / Year) / / Disposed /(Month/Day/Year) / / rity / rities / Secu- / / Deriv- / / / of (D) / / /(Inst.4)/ Benefi-/ rity: / / ative / / /(Inst.3,4,5)/ / / / cially / Direct / / Secu- / /--------/------------/-----------------/---------------/ / Owned / (D) / / rity / /Code/ V / (A) / (D) / Date / Expir-/ Title /Amount / / at End /Indirect/ / / / / / / / Exer- / ation / / or / / of / (I) / / / / / / / / cisable/ Date / /No. of / / Month /(Inst.4)/ / / / / / / / / / /shares / /(Inst.4)/ / ==================================================================================================================================== Warrants to $0.10 5/15/02 M 1,100,000 2/25/02 5/15/02 Common 1,100,000 - D N/A Purchase Stock Common Stock - ------------------------------------------------------------------------------------------------------------------------------------ Warrants to $0.10 5/15/02 A V 1,100,000 5/15/02 11/15/02 Common 1,100,000 - 14,895,015 D N/A Purchase Stock Common Stock - ------------------------------------------------------------------------------------------------------------------------------------ ==================================================================================================================================== Explanation of Responses: /S/ MICHAEL APATOFF 5/24/02 -------------------------------- ---------- Michael Apatoff Date
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----