SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
Rudolf John C

(Last) (First) (Middle)
500 108TH AVENUE
SUITE 905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
VOLT INFORMATION SCIENCES, INC. [ VISI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
01/14/2015
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock, $0.10 Par Value(1)(2) 01/14/2015 P 2,500 A $10.4134 12,500 D(8)
Common Stock, $0.10 Par Value(1)(2) 01/14/2015 P 3,436 A $10.2311 1,776,111 D(4)
Common Stock, $0.10 Par Value(1)(2) 406,714 D(3)
Common Stock, $0.10 Par Value(1)(2) 2,464,130 I By GPC as Proxy(5)(6)
Common Stock, $0.10 Par Value(1)(2) 10,000 D(7)
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Rudolf John C

(Last) (First) (Middle)
500 108TH AVENUE
SUITE 905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Glacier Peak U.S. Value Fund, L.P.

(Last) (First) (Middle)
500 108TH AVENUE NE
SUITE 905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Glacier Peak Capital LLC

(Last) (First) (Middle)
500 108TH AVENUE NE
SUITE 905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
BERGAMO ANTHONY

(Last) (First) (Middle)
C/O GLACIER PEAK CAPITAL, CITY CNTR BLDG
500 108TH AVE, NE #905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Boone James E.

(Last) (First) (Middle)
C/O GLACIER PEAK CAPITAL, CITY CNTR BLDG
500 108TH AVE, NE #905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
Gillman Charles M

(Last) (First) (Middle)
C/O GLACIER PEAK CAPITAL, CITY CNTR BLDG
500 108TH AVE, NE #905

(Street)
BELLEVUE WA 98004

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. This Form 4 is filed jointly by Glacier Peak U.S. Value Fund, L.P. (the "Fund"), Glacier Peak Capital LLC ("GPC"), John C. Rudolf, Anthony Bergamo, James E. Boone and Charles M. Gillman (collectively, the "Reporting Persons"). Each Reporting Person is a member of a reporting group that owns in the aggregate more than 10% of the Issuer's outstanding shares of Common Stock. As such, each Reporting Person may be deemed to beneficially own more than 10% of the Issuer's outstanding shares of Common Stock.
2. Each Reporting Person disclaims beneficial ownership of the shares of Common Stock reported herein except to the extent of his or its pecuniary interest therein, and this report shall not be deemed to be an admission that any Reporting Person is the beneficial owner of such shares of Common Stock for purposes of Section 16 or for any other purpose.
3. Mr. Rudolf directly owns 220,397 Shares of Common Stock, may be deemed to beneficially own 5,000 Shares of Common Stock that are held in an IRA account that he controls, may be deemed to beneficially own 30,000 Shares of Common Stock that are held in an account he controls for the benefit of his wife, and may be deemed to beneficially own 151,317 Shares of Common Stock held in various accounts he controls for the benefit of other family members.
4. Shares of Common Stock beneficially owned by the Fund. GPC, as the general partner of the Fund, may be deemed to be the beneficial owner of the shares of Common Stock beneficially owned by the Fund. Mr Rudolf, as President of GPC, may be deemed to be the beneficial owner of the shares of Common Stock beneficially owned by the Fund.
5. On October 28, 2014, GPC entered into a Voting Agreement and Irrevocable Proxy dated October 28, 2014 (the "Agreement and Proxy") with Jerome Shaw, Joyce Cutler-Shaw, The Jerome and Joyce Shaw Family Trust U/D/T dated 8/6/1969, and The Rachel Lynn Shaw Trust U/D/T dated 11/23/2001 (collectively, the "Shaws"), whereby the Shaws granted John Rudolf, in his capacity as President of GPC, or any other designee of GPC (each a "Proxy Holder") an irrevocable proxy to vote all shares beneficially owned by the Shaws, in accordance with the Proxy Holder's sole and absolute discretion on all matters brought before a vote of shareholders at the 2015 Annual Meeting of Shareholders of the Issuer or any meeting (or consent in lieu of a meeting) which may be called in lieu thereof.
6. Solely as a result of the Agreement and Proxy, GPC and Mr. Rudolf may be deemed to beneficially own the 2,472,130 shares (including 8,000 shares underlying stock options) owned by the Shaws. Each of GPC and Mr. Rudolf expressly disclaim beneficial ownership of the shares beneficially owned by the Shaws. Except for the Agreement and Proxy, the Reporting Persons and Shaws have no other arrangements, understandings or relationships regarding the shares. The Reporting Persons disclaim the formation of a group with the Shaws, except to the extent that they may be deemed to be members of a group within the meaning of Rule 13d-5(b) under the Securities Exchange Act of 1934, as amended. The Reporting Persons have no pecuniary interest in the shares subject to the Agreement and Proxy granted by the Shaws.
7. Mr. Bergamo directly owns 10,000 Shares of Common Stock.
8. Mr. Boone directly owns 12,500 Shares of Common Stock.
/s/ John C. Rudolf 01/16/2015
Glacier Peak U.S. Value Fund, L.P.; By: Glacier Peak Capital LLC; By: /s/ John C. Rudolf, as President 01/16/2015
Glacier Peak Capital LLC; By: /s/ John C. Rudolf, as President 01/16/2015
Anthony Bergamo; By: /s/ John C. Rudolf, Attorney in Fact 01/16/2015
James E. Boone; By: /s/ John C. Rudolf, Attorney in Fact 01/16/2015
Charles M. Gillman; By: /s/ John C. Rudolf, Attorney in Fact 01/16/2015
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** 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 is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.