-----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, V2J3JiCJ5L1cQDPU2pffMDhhHajHo9Ziy6ALTlLVhpgJnbZO4M/96nzyF6F1t5AL oEhNoRnbrdu+OsnZWir+rA== 0000909143-99-000283.txt : 19991216 0000909143-99-000283.hdr.sgml : 19991216 ACCESSION NUMBER: 0000909143-99-000283 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991031 FILED AS OF DATE: 19991215 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: ARDIS TELECOM & TECHNOLOGIES INC CENTRAL INDEX KEY: 0000913659 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING SERVICES [7371] IRS NUMBER: 752801677 STATE OF INCORPORATION: DE FISCAL YEAR END: 1031 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-22636 FILM NUMBER: 99775166 BUSINESS ADDRESS: STREET 1: 8100 JETSTAR DRIVE STREET 2: SUITE 100 CITY: IRVING STATE: TX ZIP: 75063 BUSINESS PHONE: 9729291920 MAIL ADDRESS: STREET 1: 8100 JETSTAR DRIVE STREET 2: SUITE 100 CITY: IRVING STATE: TX ZIP: 75063 FORMER COMPANY: FORMER CONFORMED NAME: CANMAX INC /WY/ DATE OF NAME CHANGE: 19941215 FORMER COMPANY: FORMER CONFORMED NAME: INTERNATIONAL RETAIL SYSTEMS INC/BD DATE OF NAME CHANGE: 19941215 FORMER COMPANY: FORMER CONFORMED NAME: CANMAX INC DATE OF NAME CHANGE: 19941215 COMPANY DATA: COMPANY CONFORMED NAME: DEMARE NICK CENTRAL INDEX KEY: 0001101054 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: CHASE MANAGEMENT STREET 2: 1090 W. GEORGIA, SUITE 1305 CITY: VANCOUVER STATE: A1 ZIP: 00000 5 1 ----------------------------- OMB APPROVAL ----------------------------- OMB Number 3235-0362 Expires: September 30, 1998 Estimated average burden hours per response ....... 1.0 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 5 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 [ ] CHECK THIS BOX IF NO LONGER SUBJECT OF SECTION 16. FORM 4 OR FORM 5 OBLIGATIONS MAY CONTINUE. SEE INSTRUCTION 1(B). [ ] FORM 3 HOLDINGS REPORTED. [ ] FORM 4 TRANSACTIONS REPORTED. ====================================================================== 1. Name and Address of Reporting Person DeMare Nick - ---------------------------------------------------------------------- (Last) (First) (Middle) Chase Management 1090 W. Georgia, Suite 1305 - ---------------------------------------------------------------------- (Street) Vancouver BC V6E-3V7 - ---------------------------------------------------------------------- (City) (State) (Zip) ====================================================================== 2. Issuer Name and Ticker or Trading Symbol ARDIS TELECOM & TECHNOLOGIES, INC. (RDST) ====================================================================== 3. IRS or Social Security Number of Reporting Person (Voluntary) ====================================================================== 4. Statement for Month/Year October 1999 ====================================================================== 5. If Amendment, Date of Original (Month/Year) ====================================================================== 6. Relationship of Reporting Person to Issuer (Check all applicable) [ X ] Director [ ] 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 ================================================================================================================================= 6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Nature Transaction (Instr. 3, 4 and 5) Beneficially Direct of Indirect 2. Code ------------------------------- Owned at End (D) or Beneficial 1. Transaction (Instr. 8) (A) of Issuer's Indirect Ownership Title of Security Date ------------ or Fiscal Year (I) (Instr. (Instr. 3) (mm/dd/yy) Code Amount (D) Price (Instr 3 & 4) (Instr.4) 4) - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- ================================================================================================================================= Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly
FORM 5 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ==================================================================================================================================== 9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature of Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of (D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Year (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code (A) (D) cisable Date Title Shares 5) 4) 4) 4) - --------------------------------------------------------------------------------------------------------------------------------- Employee Stock $.45 04/26/99 A 5,000 04/26/99 04/26/04 Common 5,000 5,000 D Option (right Stock to buy) - --------------------------------------------------------------------------------------------------------------------------------- Employee Stock $.40 04/26/99 A 5,000 04/26/99 04/26/01 Common 5,000 5,000 D Option (right Stock to buy) - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------------------------------- =================================================================================================================================
Explanation of Responses: /s/ NICK DEMARE 12/14/99 - -------------------------------------------- ------------- **Signature of Reporting Person 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 provided is insufficient, see Instruction 6 for procedures. -----END PRIVACY-ENHANCED MESSAGE-----