FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 02/14/2005 |
3. Issuer Name and Ticker or Trading Symbol
METALICO INC [ * ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
COMMON STOCK | 17,901 | I | see footnote(1) |
COMMON STOCK | 1,197 | I | see footnote(2) |
COMMON STOCK | 30,752 | I | see footnote(3) |
COMMON STOCK | 19,098 | I | see footnote(4) |
COMMON STOCK | 7,445 | I | see footnote(5) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
PREFERRED STOCK | 05/24/2005 | (8) | COMMON STOCK | 839,350 | $3 | I | see footnote(1) |
PREFERRED STOCK | 05/24/2004 | (8) | COMMON STOCK | 56,008 | $3 | I | see footnote(2) |
PREFERRED STOCK | 05/24/2004 | (8) | COMMON STOCK | 2,148,853 | $3 | I | see footnote(3) |
PREFERRED STOCK | 05/24/2004 | (8) | COMMON STOCK | 895,363 | $3 | I | see footnote(4) |
PREFERRED STOCK | 05/24/2004 | (8) | COMMON STOCK | 537,226 | $3 | I | see footnote(5) |
WARRANTS | 12/01/2000 | 11/30/2005 | COMMON STOCK | 15,000 | $2.92 | I | see footnote(6) |
CONVERTIBLE NOTE | 09/30/2004 | 09/30/2005 | COMMON STOCK | 80,000 | $2.75 | I | TRUSTEE(7) |
CONVERTIBLE NOTE | 11/18/2004 | 11/18/2006 | COMMON STOCK | 61,539 | $3.25 | I | TRUSTEE(7) |
WARRANT | 11/18/2004 | 11/18/2006 | COMMON STOCK | 12,308 | $4 | I | TRUSTEE(7) |
Explanation of Responses: |
1. Held By: Apex Investment Fund III, L.P. of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
2. Held By: Apex Strategic Partners, L.L.C. of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
3. Held By: Infastructure and Environmental Equity Fund III L.P. of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
4. Held By: The Productivity Fund III, L.P. of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
5. Held By: Environmental & Information Private Equity Fund III of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
6. Held By: First Analysis Securities Corporation, of which the Reporting Person may be deemed to be a beneficial owner pursuant to Rule 16-a-1(a)(2) |
7. The Bret R. Maxwell Revocable Trust |
8. No Expiration Date |
Remarks: |
Interests are held directly as indicated below in this Form 3. The Reporting Person disclaims the existence of a "group" and disclaims beneficial ownership of any securities (except to the extent of such Reporting Person's pecuniary interest in such securities) other than any securities reported herein as being directly owned by such Reporting Person and this report shall not be deemed an admission that such Reporting Person is the beneficial owner of any such securities for purpose of Section 16 or any other purpose *MLAO (Pink Sheets); MEA (Amex when effective) |
BRET R. MAXWELL | 02/14/2005 | |
** 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 5 (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. |