3 1 dec2001f3.txt HALE
F O R M 3 U.S. Securities and Exchange Commission OMB Approval Washington, D.C. 20549 OMB Number 3235-0104 Expires: September 30, 1998 Estimated ave.burden hours per response .............0.5
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section17(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 2. Date of Event Requiring 3. IRS or Soc.Sec.No. Statement (Month/Day/Yr) of Reporting Person (Voluntary) Hale Randall B. 12/21/2001 _____________________________________ _______________________ __________________ (Last) (First) (Middle) 600 Century Plaza Drive Building 140 _____________________________________ 4. Issuer Name and Ticker or Trading (Street) Symbol Industrial Data Systems Corporation (IDS) Houston TX 77073-6033 _____________________________________ _______________________________________________ (City) (State) (ZIP) 5. Relationship of Reporting Person to Issuer 6. If Amendment, Date of Original (Check all applicable) ____X_____ Director ________ 10% Owner ____________________________________ __________ Officer Other (Month/Day/Year) (give title below) (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
* If the Form is filed by more than one Reporting Person, see Instruction 5(b)(v) ------------------------------------------------------------------------------------------------------------ Table I - Non-Derivative Securities Beneficially Owned ------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Amount of 3. Ownership Form: 4. Nature of Indirect (Instr. 4) Securities Direct (D) or Beneficial Beneficially Indirect (I) Ownership Owned (Instr. 4) (Instr. 5) (Instr. 5) Held by Equus II Common Stock 1,225,758 (see note 1) (I) Incorporated (note2) ---------------------------- ---------------- ---------------- ----------------- ---------------------------- ---------------- ---------------- ----------------- ---------------------------- ---------------- ---------------- ----------------- ---------------------------- ---------------- ---------------- ----------------- ---------------------------- ---------------- ---------------- ----------------- ---------------------------- ---------------- ---------------- ----------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses)
Page 1 FORM 3 (continued) Page 2
------------------------------------------------------------------------------------------------------------ Table II - Derivative Securities Beneficially Owned (e.g. puts, calls, warrants, options, convertible securities) ------------------------------------------------------------------------------------------------------------ 1. Title of 2. Date Exercisable and 3. Title and Amount of Securities Derivative Expiration Date Underlying Derivative Security Security (Month/Day/Year) (Instr. 4) Date Expiration Amount or Number Exercisable Date Title of Shares Series A Convertible Preferred Stock 12/21/2001 12/21/2008 Common Stock 1,050,420 -------------------------- ----------- ---------- ---------------- -------------------- Option giving right to buy (see note 4) 12/21/2006 Common Stock 200,000 -------------------------- ----------- ---------- ---------------- -------------------- -------------------------- ----------- ---------- ---------------- -------------------- -------------------------- ----------- ---------- ---------------- -------------------- -------------------------- ----------- ---------- ---------------- -------------------- -------------------------- ----------- ---------- ---------------- -------------------- -------------------------- ----------- ---------- ---------------- --------------------
4. Conversion or Exercise 5. Ownership Form of 6. Nature of Indirect Beneficial Price of Derivative Derivative Security: Ownership Security Direct (D) or Indirect (I) (Instr. 5) (Instr. 4) (Instr. 5) (see note 3) (I) Held by Equus II Incorporated ---------------------------- ---------------------------------- ------------------------------ Graduated pricing (see note 5) (I) Held by Equus II Incorporated ---------------------------- ---------------------------------- ------------------------------ ---------------------------- ---------------------------------- ------------------------------ ---------------------------- ---------------------------------- ------------------------------ ---------------------------- ---------------------------------- ------------------------------ ---------------------------- ---------------------------------- ------------------------------ ---------------------------- ---------------------------------- ------------------------------
Explanation of Responses: Note 1: All of these shares are subject to a two-year trading restriction which will expire 12/21/03. Note 2: Mr. Hale is an executive officer of Equus II Incorporated, a significant debt holder of the Company. Note 3: 2,500,000 shares of Series A convertible preferred stock convertible at a rate of one share of common stock for each 2.38 shares of preferred stock. Holder of preferred stock is entitled to receive cumulative dividends at an annual rate of 8% paid in cash or in kind beginning May 31, 2002. Note 4: Grant issued by Alliance 2000 Ltd., a significant IDS stockholder, to reporting person giving option to purchase shares of Common Stock held by Alliance. The option becomes vested and is exercisable only upon the sale of the Company. Note 5: The exercise price of the Alliance 2000 Ltd option ranges from $0.75 to $1.25 over a five-year period as follows: 12/21/01 to 12/21/02 $0.75 12/21/02 to 12/21/03 $0.85 12/21/03 to 12/21/04 $0.95 12/21/04 to 12/21/05 $1.10 12/21/05 to 12/21/06 $1.25 /s/ Randall B. Hale 12/28/01 --------------------------------- ----------- **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). Page 2 of 2