3 1 g66328jpe3.txt KELLSTOM INDUSTRIES/ JACK PORTLOCK FORM 3 1 -------- FORM 3 -------- U.S. SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(1)|2. Date of Event Requiring |4. Issuer Name and Ticker or Trading Symbol | | | Statement | | | Portlock Jack | (Month/Day/Year) | Kellstrom Industries, Inc. (KELL) | |------------------------------------------| | | | (Last) (First) (Middle) | September 9, 2000 |-----------------------------------------------------------| | c/o Kellstrom Industries, Inc. | |5. Relationship of Reporting | 6. If Amendment, Date | | 1100 International Parkway |---------------------------| Person to Issuer | of Original | |------------------------------------------|3. IRS Identification | (Check all applicable) | (Month/Day/Year) | | (Street) | Number of Reporting | | | | | Person, if an Entity |[ ] Director [ ] 10% Owner | | | | (Voluntary) | | | | | |[X] Officer [ ] Other (specify| | | | | (give below) |-------------------------| | | | title below) | 7. Individual or Joint/ | | Sunrise, FL 33323 | | Senior Vice President | Group Filing (Check | |--------------------------------------------------------------------------------------------------------| applicable line) | | (City) (State) (Zip) | | | | [X] Form Filed by | | | One Reporting | | | Person | | | [ ] Form Filed by | | | More than One | | | Reporting Person | |----------------------------------------------------------------------------------------------------------------------------------| | TABLE 1 -- NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED | |----------------------------------------------------------------------------------------------------------------------------------| |1. Title of Security | 2. Amount of Securities | 3. Ownership Form: | 4. Nature of Indirect | | (Instr. 4) | Beneficially Owned | Direct (D) or | Beneficial | | | (Instr. 4) | Indirect (I) | Ownership (Instr. 4) | | | | (Instr. 5) | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | Common Stock | 2,000 | I | Spouse | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | |----------------------------------------|------------------------------|---------------------------|------------------------------| | | | | | -----------------------------------------------------------------------------------------------------------------------------------
(1) If the form is filed by more than one Reporting Person, see Instruction 5(b)(v). Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) 2
FORM 3 (CONTINUED) TABLE II -- DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) ------------------------------------------------------------------------------------------------------------------------------------ | 1. Title of Derivative Security |2. Date |3. Title and Amount of |4. Conver- | 5. Owner- |6. Nature of Indirect| | (Instr. 4) | Exercisable and | Securities Underlying | sion or | ship | Beneficial Owner- | | | Expiration Date | Derivative Securities | Exercise | Form of | ship (Instr. 5) | | | (Month/Day/Year )| (Instr. 4) | Price of | Deriva- | | | | | | Deriva- | tive | | | | | | tive | Security:| | | | | | Security | Direct | | | |--------------------|--------------------------| | (D) or | | | | Date | Expira- | | Amount or | | Indirect | | | | Exercis-| tion | Title | Number of | | (I) | | | | able | Date | | Shares | | (Instr. | | | | | | | | | 5) | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | Employee Stock Option | (1) |10/26/07 | Common Stock | 10,000 | $10.125 | D | N/A | | (right to buy) | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | Employee Stock Option | (2) | 6/18/08 | Common Stock | 5,000 | $10.125 | D | N/A | | (right to buy) | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | |---------------------------------|----------|---------|--------------|-----------|------------|-------------|---------------------| | | | | | | | | | ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: (1) These Employee Stock Options vest in three equal installments on 4/28/99; 10/28/00 and 4/28/02. (2) These Employee Stock Options vest in two equal installments on 6/18/01 and 12/18/02. ------------------------- /s/ Jack Portlock 1/5/01 * Intentional misstatements or omissions of facts constitute Federal Criminal --------------------------------- ---------- Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Signature of Reporting Person * Date Jack Portlock Note: File three copies of this form, one of which must be manually signed. If space provided is insufficient, see Instruction 6 for procedure. (Print or Type Responses) Page 2