SEC Info - Harizman Niv - ‘5’ for 12/31/99 re: Kellstrom Industries Inc.

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

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

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

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

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34
Filing Table of Contents

Document/Exhibit                   Description                      Pages   Size 

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

5 1st Page of 2 TOC ↑Top Previous Next ↓Bottom Just 1st
 

------                                                                          
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.)

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

As of: 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

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34Filing Table of Contents

Annual Statement of Changes in Beneficial Ownership of Securities by an Insider — Form 5 — SEA’34
Filing Table of Contents