5 1 d5.txt FORM 5 +--------+ | FORM 5 | U.S SECURITIES AND EXCHANGE COMMISSION +--------+ Washington, D.C. 20549 [_] Check box if no longer subject ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP to Section 16. Form 4 or Form 5 Filed pursuant to Section 16(a) of the Securities obligations may Exchange Act of 1934, Section 17(a) of the continue. See Public Utility Holding Company Act of 1935 or Instruction 1(b). Section 30(f) of the Investment Company Act of 1940 [_] Form 3 Holdings Reported [X] Form 4 Transactions Reported -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person* MICELI JEROME F. ---------------------------------------------------------------------------- (Last) (First) (Middle) 250 PARK AVENUE S. SUITE 200 ---------------------------------------------------------------------------- (Street) WINTER PARK FL 32789 ---------------------------------------------------------------------------- (City) (State) (Zip) -------------------------------------------------------------------------------- 2. Issuer Name and Ticker or Trading Symbol INTERNATIONAL ASSETS HOLDING CORPORATION -- IAAC -------------------------------------------------------------------------------- 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) -------------------------------------------------------------------------------- 4. Statement for Month/Year DECEMBER, 2001 -------------------------------------------------------------------------------- 5. If Amendment, Date of Original (Month/Year) -------------------------------------------------------------------------------- 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) [X] Director [_] Officer [_] 10% Owner [_] Other (give title below) (specify below) -------------------------------------------------------------------------------- 7. Individual or Joint/Group Reporting (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. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Month/ (Instr. 8) -------------------------- Owned at Direct Bene- Day/ ------------- End of (D) or ficial Year) Issuer's Indirect Owner- (A) or Fiscal Year (I) ship Amount (D) Price (Instr. 3 and 4) (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ International Jerome and Assets Holding Rosalie Corp. Common 04/02/01 S4 1000 D $2.5312 41,468 I Miceli Trst ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
* If the form is filed by more than one reporting person, see instruction 4(b)(v). Reminder: Report on a separate line for each class of securities benefically 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)
----------------------------------------------------------------------------------------------------------------------------- 1. Title of Derivative 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- Security (Instr. 3) sion or action tion Code ative Securities Exercise Date (Instr. 8) Acquired (A) or Price of (Month/ Disposed of (D) Deriv- Day/ (Instr. 3, 4, and 5) ative Year) security --------------------------- (A) (D) ----------------------------------------------------------------------------------------------------------------------------- International Assets Holding Corp. Options 0.90 10/5/01 J4* 15,000 ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------------------------ 6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Na- cisable and Underlying Securities of of Deriv- ship ture Expiration (Instr. 3 and 4) Deriv- ative of De- of In- Date ative Secur- rivative direct (Month/Day/ Secur- ities Secu- Bene- Year) ity Bene- rity: ficial (Instr. 5) ficially Direct Owner- -------------------------------------------- Owned (D) or ship Date Expira- Amount or at End Indi- (Instr. 4) Exer- tion Number of of Year rect (1) cisable Date Shares (Instr. 4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ 10/5/02** 10/05/11 Common 15,000 0.90 7,500 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------
================================================================================ Explanation of Responses: *GRANT OF OPTIONS FROM ISSUER **5,000 exercisable on 10/5/02; another 5,000 exercisable on 10/5/03; the additional 5,000 exercisable on 10/5/04. /S/ JEROME F. MICELI 01/07/02 ------------------------------------- ----------------- **Signature of Reporting Person Date ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 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 procedure.