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Harizman Niv – ‘5’ for 12/31/99 re: Kellstrom Industries Inc

On:  Wednesday, 2/16/00   ·   For:  12/31/99   ·   Accession #:  950144-0-2406   ·   File #:  0-23764

Previous ‘5’:  ‘5’ on 11/16/99 for 12/31/98   ·   Latest ‘5’:  This Filing

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  As Of                Filer                Filing    For·On·As Docs:Size              Issuer               Agent

 2/16/00  Harizman Niv                      5          Director    1:10K  Kellstrom Industries Inc          Bowne of Atlanta Inc/FA

Annual Statement of Change in Beneficial Ownership of Securities   —   Form 5
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

 1: 5           Kellstrom Industries/ Niv Harizman Form 5              2     19K 

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------ 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 [Enlarge/Download Table] ------------------------------------------------------------------------------------------------------------------------------------ | 1. Name and Address of Reporting Person(1) | 2. Issuer Name and Ticker or Trading Symbol |6. Relationship of Reporting Person to | | Harizman Niv | Kellstrom Industries, Inc. (KELL) | Issuer (Check all applicable) | |--------------------------------------------|---------------------------------------------| | | (Last) (First) (Middle) | 3. IRS Identification |4. Statement For | [X] Director [ ] 10% Owner | | c/o Kellstrom Industries, Inc. | Number of Reporting | Month/Year | | | 1100 International Parkway | Person, if an Entity | 12/99 | [ ] Officer (give [ ] Other (specify| |--------------------------------------------| (Voluntary) |-------------------| title below) | | (Street) | |5. If Amendment, | below) | | | | Date of Original| | | | | (Month/Year) |---------------------------------------| | Sunrise FL 33323 | | |7. Individual or Joint/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 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) | | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | |--------------------------|-----------------|-------------|--------|--------|--------|-------------------|-------------|----------| | | | | | | | | | | ----------------------------------------------------------------------------------------------------------------------------------- * If 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.
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[Enlarge/Download Table] 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 Option | $19.00/sh. | 06/04/99 | A |30,000 | -- |06/04/99|06/04/99|Common| 30,000 | -- | |(right to buy) | | | | | | | |Stock | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | |-----------------------|------------|-----------|-----------|-------|--------|--------|--------|------|------------|--------------| | | | | | | | | | | | | ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------ | 9. Number of | 10. Ownership | 11. Nature of | | Derivative | of Derivative | Indirect | | Securities | Security: | Beneficial | | Beneficially | Direct (D) | Ownership | | Owned at End | or Indirect (I) | (Instr. 4) | | of Year | (Instr. 4) | | | (Instr. 4) | | | | | | | |--------------------|--------------------------|----------------------| | 30,000 | D | N/A | |--------------------|--------------------------|----------------------| | | | | |--------------------|--------------------------|----------------------| | | | | |--------------------|--------------------------|----------------------| | | | | |--------------------|--------------------------|----------------------| | | | | |--------------------|--------------------------|----------------------| | | | | ------------------------------------------------------------------------ Explanation of Responses: (1) Intentional misstatements or omissions of facts constitute Federal Criminal /s/ Niv Harizman 2/15/2000 Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------------- ---------- **Signature of Reporting Person (1) Date Niv Harizman 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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Filing Submission 0000950144-00-002406   –   Alternative Formats (Word / Rich Text, HTML, Plain Text, et al.)

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