-----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, B+Cv8EwfM2QgYe2nXccr3w9jPl89D9nRWdKV2bNg3BmPY1LMUTTErRVRjnU609E3 82ZIJYX4pzyQBO+21KtLzw== /in/edgar/work/20000810/0001082504-00-000030/0001082504-00-000030.txt : 20000921 0001082504-00-000030.hdr.sgml : 20000921 ACCESSION NUMBER: 0001082504-00-000030 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000123 FILED AS OF DATE: 20000810 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: SMARTSERV ONLINE INC CENTRAL INDEX KEY: 0001005698 STANDARD INDUSTRIAL CLASSIFICATION: [7374 ] IRS NUMBER: 133750708 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 3/A SEC ACT: SEC FILE NUMBER: 000-28008 FILM NUMBER: 690829 BUSINESS ADDRESS: STREET 1: METRO CENTER STREET 2: ONE STATION PLACE CITY: STAMFORD STATE: CT ZIP: 06902 BUSINESS PHONE: 2033535950 MAIL ADDRESS: STREET 1: ONE STATION PLACE CITY: STAMFORD STATE: CT ZIP: 06902 COMPANY DATA: COMPANY CONFORMED NAME: KIMBERLIN KEVIN CENTRAL INDEX KEY: 0000904841 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OWNER FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: SPENCER TRASK SECURITIES INC STREET 2: 535 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2123555565 3/A 1 0001.txt KIMBERLIN - AMENDED U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL 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: Kimberlin, Kevin B. 535 Madison Avenue, 18th Floor New York, NY 10022 2. Date of Event Requiring Statement: (Month/Day/Year) 1/23/2000 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol: SmartServ Online, Inc. SSOL 5. Relationship of Reporting Person to Issuer: [ ] Director [ x ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ------------------------------------------- 6. If Amendment, Date of Original: 3/9/2000 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 Beneficially Owned - -------------------------------------------------------------------------------- 1)Title of Security 2) Amount of 3) Ownership 4) Nature of Securities Form:Direct Indirect Beneficially (D) or Beneficial Owned at End Indirect(I) Ownership of Month - -------------------------------------------------------------------------------- N/A
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) 1)Title of Derivative 2) Date Exer- 3)Title & Amount 4) Conversion 5)Ownership 6) Nature of Security cisable and of Underlying or Exercise form of Indirect Expiration Securities Price of Derivative Beneficial Date Derivative Security Ownership Security Direct (D) or Indirect(I) Date Expira- Title Amount or Exer- tion Number of cisable Date Shares - --------------------------------------------------------------------------------------------------------------- Warrants to Purchase 1/23/00 11/24/03 Common Stock 427,500 $0.60 I See note (1) Common Stock Warrants to Purchase 1/25/00 11/24/03 Common Stock 112,000 $0.60 I See note (2) Common Stock - ---------------------------------------- Explanation of Responses: (1) Kevin Kimberlin Partners, LP, a Delaware limited partnership, of which the reporting person is the general partner, received a direct issuance, as of January 23, 2000, of 427,500 warrants from the Issuer to purchase common stock of the Issuer. (2) Spencer Trask Holdings, Inc., a Delaware corporation, of which the reporting person is the controlling shareholder, received, on January 25, 2000, a direct issuance of 112,000 warrants from the Issuer to purchase common stock of the Issuer.
**Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a) /s/ Kevin B. Kimberlin August 9, 2000 ------------------------------- ---------------------- **Signature of Reporting Person Date
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