SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL 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
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response: 1.0
  
 Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
 Form 3 Holdings Reported.
  
 Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Shaw Deborah
(Last) (First) (Middle)
2908 MAPLE AVENUE
(Street)
MANHATTAN BEACH CA 90266
(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)
X Director 10% Owner
Officer (give title below) Other (specify below)
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
10/30/2011
4. If Amendment, Date of Original Filed (Month/Day/Year)
 6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common Stock, $0.10 par value 320,416(1) D
Common Stock, $0.10 par value 12/01/2010 G 230,142 D $0 1,332,369(1) I By GRATs(2)
Common Stock, $0.10 par value 06/09/2011 G 29,688 D $0 1,262,857(1) I By GRATs(2)
Common Stock, $0.10 par value 71,220 I As custodian(3)(4)
Common Stock, $0.10 par value 23,019 I By Spouse(4)
Common Stock, $0.10 par value 34,584 I By Spouse as custodian(4)(6)
Common Stock, $0.10 par value 12/01/2010 G 230,142 A $0 230,142 I By Spouse as Co-Trustee(3)(5)
Common Stock, $0.10 par value 06/09/2011 G 29,688 A $0 259,830 I By Spouse as Co-Trustee(3)(5)
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)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option (Right to Buy) $6.39 (7) 04/06/2019 Common Stock, $0.10 par value 3,000 3,000 D
Explanation of Responses:
1. Column 5 of Table 1 gives effect to all transactions, including contributions to, and all annuity distributions from, Grantor Retained Annuity Trusts ("GRATs") created by the reporting person through the date set forth in Column 2 (except that the final amount shown as owned directly or through GRATs is at the end of the fiscal year covered by this Report). Certain of the transactions may not be reportable and, therefore, amounts shown in Column 5 may not foot to the amount previously reported as owned.
2. Held by Grantor Retained Annuity Trusts ("GRATs") created by, and the sole trustee and sole annuitant of which is, the reporting person are exempt from reporting pursuant to Rule 16a-13.
3. Held by the reporting person as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
4. The filing of this statement shall not be construed as an admission that the reporting person is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of these securities.
5. Held by the reporting person's spouse and his sister as co-trustees of trusts for the benefit of the children of the reporting person.
6. Held by the reporting person's spouse as custodian under the California Uniform Transfers to Minors Act for the benefit of children of the reporting person.
7. The option is exercisable in 20% annual installments, on a cumulative basis, commencing April 7, 2010, one year after the date of grant of the option.
Remarks:
/s/ Deborah Shaw 12/14/2011
** 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.