-----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, I9vfX0PUxQ0+jD9zQxoNAzHCRjaYRjfswIVUmtCTZC/SBlV5edduh46BzVybyUtD e33iFMheHEiUA8RCiH5YGA== /in/edgar/work/20000810/0001082504-00-000033/0001082504-00-000033.txt : 20000921 0001082504-00-000033.hdr.sgml : 20000921 ACCESSION NUMBER: 0001082504-00-000033 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000331 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: 4 SEC ACT: SEC FILE NUMBER: 000-28008 FILM NUMBER: 690881 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: 4 BUSINESS ADDRESS: STREET 1: SPENCER TRASK SECURITIES INC STREET 2: 535 MADISON AVENUE CITY: NEW YORK STATE: NY ZIP: 10022 BUSINESS PHONE: 2123555565 4 1 0001.txt KIMBERLIN U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 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 [ x ] Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue 1. Name and Address of Reporting Person: Kimberlin, Kevin B. 535 Madison Avenue, 18th Floor New York, NY 10022 2. Issuer Name and Ticker or Trading Symbol: SmartServ Online, Inc. SSOL 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year: March 2000 5. If Amendment, Date of Original: 6. Relationship of Reporting Person to Issuer: [ ] Director [ x ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ------------------------------------------- 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 Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------- 1)Title of Security 2)Transaction 3)Transaction 4) Securities Acquired(A) 5) Amount of 6) Ownership 7) Nature of Date Code or Disposed of (D) Securities Form:Direct Indirect --------------- -------------------------- Beneficially (D) or Beneficial (Month/Day/ Owned at End Indirect(I) Ownership Year) Code V Amount (A) or (D) Price of Month - ------------------------------------------------------------------------------------------------------------------------- N/A - -------------------------------------------------------------------------------------------------------------------------
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ----------------------------------------------------------------------------------------------------------------------------------- 1)Title of Derivative 2)Conversion or 3)Transaction 4)Transaction 5) Number of Derivative 6) Date Exercisable Security or Exercise Price Date Code Securities Acquired(A) and Expiration Price of or Disposed of (D) Date Derivative (Month/Day/ Security Year) Date Expiration Code V (A) (D) Exercisable Date - ----------------------------------------------------------------------------------------------------------------------------------- Warrants to Purchase $0.60 3/1/00 S D 1/23/00 11/24/03 Common Stock Warrants to Purchase $0.60 3/2/00 S D 1/23/00 11/24/03 Common Stock - ----------------------------------------------------------------------------------------------------------------------------------- Table Cont'd 1)Title of Derivative 2)Conversion or 3)Transaction 7)Title & Amount 8) Price of 9) Number 10) Ownership 11) Nature of Security Exercise Price Date of Underlying Derivative of derivative form of Indirect of Derivative Securities Security securities Derivative Beneficial Security (Month/Day/ Beneficially Security Ownership Year) Owned at Direct (D) End of or Indirect(I) Month Title Amount or Number of Shares - ----------------------------------------------------------------------------------------------------------------------------------- Warrants to Purchase $0.60 3/1/00 Common 100,000 $119.625 I See Note (2) Common Stock Stock See Note (1) Warrants to Purchase $0.60 3/1/00 Common 50,000 $119.625 339,500 I See Note (2) Common Stock Stock See Note (1) - ---------------------------------------- Explanation of Responses: 1. The sales price is subject to adjustment 2. Kevin Kimberlin Partners, LP ("KKP"), a Delaware limited partnership, of which the reporting person is the general partne, sold to unrelated third parties, 150,000 of its warrants to purchase common stock of the Issuer, the exercise price of which was made by delivery of a promissory note. Following such transactions, the reporting person can be deemed to beneficially own warrants to purchase 339,500 shares of the Issuer's common stock, which includes warrants to purchase 277,500 shares held by KKP and warrants to purchase 62,000 shares held by Spencer Trask Holdings, Inc., a Delaware corporation, of which the reporting person is the controlling shareholder. - --------------------------------------------------------------------------------
**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 -----END PRIVACY-ENHANCED MESSAGE-----