-----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, IgTbfPPnUrF5v7+nKpFDX/T6sopz3uBlc6UMIAarY41JEbkgSFMVTESZRGrz7rpY L5NezOItDw9P7UT+SZJe/Q== 0000950124-97-000822.txt : 19970222 0000950124-97-000822.hdr.sgml : 19970222 ACCESSION NUMBER: 0000950124-97-000822 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970214 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: VALUEVISION INTERNATIONAL INC CENTRAL INDEX KEY: 0000870826 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 411673770 STATE OF INCORPORATION: MN FISCAL YEAR END: 0131 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-41757 FILM NUMBER: 97533352 BUSINESS ADDRESS: STREET 1: 6740 SHADY OAK RD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344-3433 BUSINESS PHONE: 6129475200 MAIL ADDRESS: STREET 1: 6740 SHADY OAK RAOD CITY: EDEN PRAIRIE STATE: MN ZIP: 55344-3433 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: JAKSICH NICHOLAS M CENTRAL INDEX KEY: 0000903717 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 6740 SHADY OAK ROAD CITY: MINNEAPOLIS STATE: MN ZIP: 55434 BUSINESS PHONE: 6129475200 MAIL ADDRESS: STREET 1: 6740 SHADY OAK ROAD CITY: MINNEAPOLIS STATE: MN ZIP: 55434 SC 13G 1 FORM SC 13G 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 VALUEVISION INTERNATIONAL, INC. - ------------------------------------------------------------------------------- (Name of Issuer) Common Stock, S.01 par value - ------------------------------------------------------------------------------- (Title of Class of Securities) 92047K 10 7 -------------------- (CUSIP Number) Page 1 of 5 Pages 2 CUSIP NO. 92047K 10 7 13G PAGE 2 OF 5 PAGES - ------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Nicholas M. Jaksich ####-##-#### - ------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) / / (b) / / - ------------------------------------------------------------------------------- 3 SEC USE ONLY - ------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION: USA - ------------------------------------------------------------------------------- 5 SOLE VOTING POWER: 1,596,762 NUMBER OF --------------------------------------------------------------- SHARES 6 SHARED VOTING POWER: BENEFICIALLY OWNED BY N/A EACH --------------------------------------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER: PERSON WITH 1,596,762 --------------------------------------------------------------- 8 SHARE DISPOSITIVE POWER: N/A - ------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON: 1,596,762 - ------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* /x/ - ------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW 9: 5.4 (based on number of outstanding shares as of 2/7/97 -- 28,884,498) - ------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - ------------------------------------------------------------------------------- 2 3 13G(Individuals - continued) PAGE 3 OF 5 PAGES Item 1(a) and (b) NAME AND ADDRESS OF ISSUER: ValueVision International, Inc. 6740 Shady Oak Road Minneapolis, MN 55344-3433 Item 2(a) NAME OF PERSON FILING: Nicholas M. Jaksich Item 2(b) ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: 6740 Shady Oak Road Minneapolis, MN 55344-3433 Item 2(c) CITIZENSHIP: U.S.A. Item 2(d) TITLE OF CLASS OF SECURITIES: Common Stock, $.01 par value Item 2(e) CUSIP NUMBER: 92047K 10 7 Item 3 THIS STATEMENT IS NOT FILED PURSUANT TO RULES 13d-1(b) OR 13d-2(b). Item 4(a) AMOUNT BENEFICIALLY OWNED: 1,596,762 shares as of December 31, 1996. (Includes right to acquire 450,000 shares to pursuant to options which are vested as of the date hereof.) Item 4(b) PERCENT OF CLASS: 5.4% percent pursuant to Rule 13d-3(c). Item 4(c) NUMBER OF SHARES AS TO WHICH SUCH PERSON HAS (1) Sole power to vote or to direct the vote 1,596,762 (2) Shared power to vote or to direct the vote -0- (3) Sole power to dispose or to direct the disposition of 1,596,762 (4) Shared power to dispose or to direct the disposition of -0- Item 5 OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS. Not Applicable Item 6 OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not Applicable Item 7 IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. Not Applicable Item 8 IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP. Not Applicable Item 9 NOTICE OF DISSOLUTION OF GROUP. Not Applicable Item 10 CERTIFICATION. Not Applicable 4 PAGE 4 OF 5 PAGES SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Date February 13, 1997. s/ Nicholas M. Jaksich - ---- ---------------------- Nicholas M. Jaksich 5 13G(Individuals - continued) PAGE 5 OF 5 PAGES EXHIBIT A To Form 13G (Individual) The filing of this report shall not be construed as an admission by the person identified in Item 2(a) that, for the purpose of Section 13(d) or 13(g) of the Securities Exchange Act, he is the "beneficial owner" of any equity securities listed below; and such person expressly disclaims that he is part of a "group." Record Owner's Relationship Record Owner's Number to Reporting Person Type of Ownership of Shares --------------------------- ----------------- --------- Son(1) Indirect 11,060(2) (1) Son shares principal residence of the Reporting Person. (2) These shares are not reported in Item 4(a) and are noted here for information only. -----END PRIVACY-ENHANCED MESSAGE-----