-----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, VcGKQrFDBcvXv24JyVXET4adt3mn7JkGyvsMhrZcoJVkjvCKBET54c1JWTwAR3Ih htaETiQew2hgelNsqRF5AQ== 0000950144-99-001834.txt : 19990217 0000950144-99-001834.hdr.sgml : 19990217 ACCESSION NUMBER: 0000950144-99-001834 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19981201 FILED AS OF DATE: 19990216 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: KELLSTROM INDUSTRIES INC CENTRAL INDEX KEY: 0000918275 STANDARD INDUSTRIAL CLASSIFICATION: AIRCRAFT ENGINES & ENGINE PARTS [3724] IRS NUMBER: 133753725 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-23764 FILM NUMBER: 99540391 BUSINESS ADDRESS: STREET 1: 1100 INTERNATIONAL PARKWAY CITY: SUNRISE STATE: FL ZIP: 33325 BUSINESS PHONE: 9548450427 MAIL ADDRESS: STREET 1: 1100 INTERNATIONAL PARKWAY CITY: SUNRISE STATE: FL ZIP: 33325 FORMER COMPANY: FORMER CONFORMED NAME: ISRAEL TECH ACQUISITION CORP DATE OF NAME CHANGE: 19940301 COMPANY DATA: COMPANY CONFORMED NAME: VON HUSEN FRED CENTRAL INDEX KEY: 0001070117 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: SAWGRASS CORPORATE INDUSTRIAL PARK STREET 2: 14000 NW 4TH ST CITY: SUNRISE STATE: FL ZIP: 33325 BUSINESS PHONE: 9548450427 MAIL ADDRESS: STREET 1: SAWGRASS CORPORATE INDUSTRIAL PARK STREET 2: 14000 NW 4TH ST CITY: SUNRISE STATE: FL ZIP: 33325 5 1 KELLSTROM INDUSTRIES/FRED VON HUSEN FORM 5 1 - ------ FORM 5 - ------ / / CHECK BOX IF NO U.S. SECURITIES AND EXCHANGE COMMISSION LONGER SUBJECT TO WASHINGTON, DC 20549 SECTION 16. FORM 4 OR FORM 5 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OBLIGATIONS MAY CONTINUE. SEE Filed pursuant to Section 16(a) of the Securities INSTRUCTION 1(b) Exchange Act of 1934, / / FORM 3 HOLDINGS Section 17(a) of the Public Utility REPORTED Holding Company Act of 1935 or Section 30(f) of / / FORM 4 the Investment Company Act TRANSACTIONS of 1940 REPORTED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name and Ticker or Trading Symbol 6. Relationship of Reporting Person to von Husen Fred Kellstrom Industries, Inc. (KELL) Issuer (Check all applicable) - ------------------------------------------- ---------------------------------------------- Director 10% Owner (Last) (First) (Middle) 3. IRS Identification 4. Statement for ---- --- c/o Kellstrom Industries, Inc. Number of Reporting Month/Year X Officer (give Other (specify 1100 International Parkway Person, if an Entity 12/98 ---- title --- below) - ------------------------------------------- (Voluntary) ------------------- below) (Street) 5. If Amendment, Executive Vice President Sunrise FL 33323 Date of Original ------------------------------- - ------------------------------------------- (Month/Year) (City) (State) (Zip) 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 1 -- NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Transac- 4. Securities Acquired (A) 5. Amount of Se- 6. Owner- 7. Nature (Instr. 3) action tion or Disposed of (D) curities Benefi- ship of In- Date Code (Instr. 3, 4 and 5) cially Owned at Form: direct (Instr. End of Issuer's Direct Benefi- (Month/ 8) Fiscal Year (D) or cial Day/ ---------------------------- (Instr. 3 and 4) Indirect Owner- Year) Amount (A) or Price (I) ship (D) (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock -- -- -- -- -- 1,000 shares D N/A - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ *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 beneficially owned directly or indirectly. (Over) (Print or Type Responses)
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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. Trans- 5. Number of 6. Date Exer- 7. Title and Amount 8. Price Security sion or action action Derivative cisable and of Underlying of (Instr. 3) Exercise Date Code Securities Expiration Securities Deriv- Price of (Month/ (Instr. Acquired (A) Date (Instr. 3 and 4) ative Deriv- Day/ 8) or Disposed (Month/Day/ Secur- ative Year) of (D) Year) ity Security (Instr. 3, (Instr. 5) 4, and 5) --------------------------------------- Date Expira- Amount or -------------- Exer- tion Title Number of (A) (D) cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $10.125/sh. 10/08/98 A 25,000 -- (1) 10/08/08 Common Stock 25,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $10.125/sh. 10/08/98 A 30,000 -- (2) 10/08/08 Common Stock 30,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $18.63/sh. 10/08/98 D -- 25,000 (3) 10/27/07 Common Stock 25,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $25.75/sh. 10/08/98 D -- 30,000 06/19/01 06/19/08 Common Stock 30,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $8.38/sh. -- -- -- -- (4) 01/02/07 Common Stock 50,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ Employee Stock Options $7.75/sh. -- -- -- -- (5) 01/15/07 Common Stock 30,000 -- (Right to buy) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------- 1. Title of Derivative 9. Number of 10. Ownership 11. Nature of Security Derivative of Derivative Indirect (Instr. 3) Securities Security: Beneficial Beneficially Direct (D) Ownership Owned at End or Indirect (I) (Instr. 4) of Year (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 25,000 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 30,000 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 0 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 0 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 50,000 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Employee Stock Options 30,000 D N/A (Right to buy) - ------------------------------------------------------------------------------------------------------- Explanation of Responses: (1) These Employee Stock Options vest in three equal installments on 4/27/99, 10/27/00, and 04/27/02. (2) These Employee Stock Options vest in two equal installments on 06/19/01 and 12/19/02. (3) These Employee Stock Options were to vest in three equal installments on 10/27/98, 10/27/99 and 10/27/00. (4) These Employee Stock Options were acquired 01/02/97 and vest in three equal installments on 01/02/98, 01/02/99 and 01/02/00. (5) These Employee Stock Options were acquired 10/25/96 and vest in three equal installments on 01/15/98, 01/15/99 and 01/15/00. **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. /s/ Fred von Husen 2/11/99 See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ------------------------------- ------- **Signature of Reporting Person Date Fred von Husen Note. File three copies of this form, one of which must be manually signed. Page 2 If space provided is insufficient, see Instruction 6 for procedure.
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