-----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, TyN8QrcnqjIyqKalvaYyt7UDxHRAzl/MfGnOmHg7ToxPD9LmXfxSdin1X0VPWm26 SxNusOtvRMZL2t/8nnNDcg== 0000890566-97-000765.txt : 19970409 0000890566-97-000765.hdr.sgml : 19970409 ACCESSION NUMBER: 0000890566-97-000765 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19970328 FILED AS OF DATE: 19970408 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INDUSTRIAL DATA SYSTEMS CORP CENTRAL INDEX KEY: 0000933738 STANDARD INDUSTRIAL CLASSIFICATION: ELECTRONIC COMPUTERS [3571] IRS NUMBER: 760157248 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-22061 FILM NUMBER: 97576191 BUSINESS ADDRESS: STREET 1: 600 CENTURY PLZ STREET 2: BLDG 140 CITY: HOUSTON STATE: TX ZIP: 77073-6016 BUSINESS PHONE: 2818213200 MAIL ADDRESS: STREET 1: 600 CENTURY PLAZA DR STREET 2: BLDG 140 CITY: HOUSTON STATE: TX ZIP: 77073-6016 COMPANY DATA: COMPANY CONFORMED NAME: COSKEY WILLIAM A CENTRAL INDEX KEY: 0001037263 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 600 CENTURY PLAZA DRIVE STREET 2: BUILDING 140 CITY: HOUSTON STATE: TX ZIP: 77073 BUSINESS PHONE: 2818213200 MAIL ADDRESS: STREET 1: 600 CENTURY PLAZA DRIVE STREET 2: BUILDING 140 CITY: HOUSTON STATE: TX ZIP: 77073 5 1 FORM 5 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 [ ] Check box if no longer subject to Section 16. Form 4 or Form 5 ANNUAL STATEMENT OF CHANGES obligations may continue. See IN BENEFICIAL OWNERSHIP Instructions 1(b). 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 Coskey William A. - ----------------------------------------------------- (Last) (First) (Middle) 600 Century Plaza Dr Building 140 - ----------------------------------------------------- (Street) Houston, TX 77073 - ----------------------------------------------------- (City) (State) (Zip) _______________________________________________________________________________ 2. Issuer Name and Ticker or Trading Symbol Industrial Data Systems Corporation ("IDDS") _______________________________________________________________________________ 3. IRS or Social Security Number of Reporting Person (Voluntary) _______________________________________________________________________________ 4. Statement for Month/Year 1996 _______________________________________________________________________________ 5. If Amendment, Date of Original (Month/Year) _______________________________________________________________________________ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] 10% Owner [X] Director [X] Officer (give title below) [ ] Other (specify below) President & CEO --------------------------------------------------------------------------- --------------------------------------------------------------------------- TABLE I--Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - ------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. - --------------------- -------- ---------- ------------------------------ ----------- ---------- ---------- Amount of Owner- Securities ship Trans- Trans- Securities Acquired (A) Beneficially Form: action action or Disposed of (D) Owned at Direct Nature of Date Code (Instr. 3, 4 and 5) End of (D) or Indirect Title of (Month/ (Instr. 8) ---------------------------- Fiscal Year Indirect Beneficial Security Day/ ---------- Amount (A) or Price (Instr. (I) Ownership (Instr. 3) Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4) - --------------------- -------- ---- ---- ----------- ------ --------- ----------- ---------- ---------- Common Stock, $.001 par value I 4,750,000 D 12,800 I Trustee for minor children
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) Page 2 FORM 5 (continued) TABLE II--Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g. puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------------ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. - ---------- -------- -------- -------- ---------- ------------ -------------- ------ ---------- --------- ---------- Title and Ownership Number of Date Exer- Amount of Form of Derivative cisable and Underlying Number of Deriv- Securities Expiration Securities Price Derivative ative Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security: sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership (Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4) - ---------- -------- -------- ---- --- ---- ---- ------- ----- ----- ------ ------ ---------- -------- ----------
Explanation of Responses: - ----------------------------------------------------- - ----------------------------------------------------- /s/ ---------------------------------------- -------------------- ** 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 procedure. -----END PRIVACY-ENHANCED MESSAGE-----