SEC Form 3
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*
DOUGLAS KEVIN

(Last) (First) (Middle)
125 E SIR FRANCIS DRAKE BLVD, STE 400

(Street)
LARKSPUR CA 94939

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/30/2012
3. Issuer Name and Ticker or Trading Symbol
Fuel Systems Solutions, Inc. [ FSYS ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) X Other (specify below)
13(d)(3) Group
5. 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 Beneficially Owned
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 789,238 D (1) (2)
Common Stock 681,126 I (2) (3) By James Douglas and Jean Douglas Irrevocable Descendants' Trust
Common Stock 335,429 I (2) (4) By Douglas Family Trust
Common Stock 197,307 I (2) (5) By James E. Douglas III
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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
Short Put Option (obligation to buy) (6) 02/18/2012 Common Stock 80,000 17 D (1) (2)
Short Put Option (obligation to buy) (6) 02/18/2012 Common Stock 66,000 17 I (2) (3) By James Douglas and Jean Douglas Revocable Descendants' Trust
Short Put Option (obligation to buy) (6) 02/18/2012 Common Stock 34,000 17 I (2) (4) By Douglas Family Trust
Short Put Option (obligation to buy) (6) 02/18/2012 Common Stock 20,000 17 I (2) (5) By James E Douglas III
Short Put Option (obligation to buy) (6) 03/17/2012 Common Stock 41,600 17 D (1) (2)
Short Put Option (obligation to buy) (6) 03/17/2012 Common Stock 34,300 17 I (2) (3) By James Douglas and Jean Douglas Revocable Descendants' Trust
Short Put Option (obligation to buy) (6) 03/17/2012 Common Stock 17,700 17 I (2) (4) By Douglas Family Trust
Short Put Option (obligation to buy) (6) 03/17/2012 Common Stock 10,400 17 I (2) (5) By James E Douglas III
1. Name and Address of Reporting Person*
DOUGLAS KEVIN

(Last) (First) (Middle)
125 E SIR FRANCIS DRAKE BLVD, STE 400

(Street)
LARKSPUR CA 94939

(City) (State) (Zip)
1. Name and Address of Reporting Person*
DOUGLAS FAMILY TRUST

(Last) (First) (Middle)
125 E. SIR FRANCIS DRAKE BLVD., STE 400

(Street)
LARKSPUR CA 94939

(City) (State) (Zip)
1. Name and Address of Reporting Person*
JAMES & JEAN DOUGLAS IRREVOCABLE DESCENDANTS TRUST

(Last) (First) (Middle)
125 E. SIR FRANCIS DRAKE BLVD., STE 400

(Street)
LARKSPUR CA 94939

(City) (State) (Zip)
1. Name and Address of Reporting Person*
DOUGLAS JAMES E III

(Last) (First) (Middle)
125 E. SIR FRANCIS DRAKE BLVD., STE 400

(Street)
LARKSPUR CA 94939

(City) (State) (Zip)
Explanation of Responses:
1. These shares are held directly and jointly by Kevin Douglas and his wife, Michelle Douglas.
2. Each of the reporting persons hereunder (individually, a "Reporting Person" and collectively, the "Reporting Persons") may be deemed a member of a "group" within the meaning of Section 13(d)(3) of the Securities and Exchange Act of 1934, as amended (the "Exchange Act"), or Rule 13d-5 promulgated under the Exchange Act with one or more of the other Reporting Persons. Although the Reporting Persons are reporting such securities as if they were members of a "group", the filing of this Form 3 shall not be deemed an admission by any Reporting Person that such Reporting Person is a beneficial owner of any securities other than those directly held by such Reporting Person.
3. These shares are held directly by the James Douglas and Jean Douglas Irrevocable Descendants' Trust and indirectly by Kevin Douglas. Kevin Douglas and Michelle Douglas, husband and wife, are each a co-trustee of the James Douglas and Jean Douglas Irrevocable Descendants' Trust.
4. These shares are held directly by the Douglas Family Trust and indirectly by Kevin Douglas. James E. Douglas, Jr. and Jean A. Douglas, husband and wife, are each a co-trustee of the Douglas Family Trust.
5. These shares are held directly by James E. Douglas, III and indirectly by Kevin Douglas.
6. This option is exercisable at any time up to and including the expiration date.
/s/ Eileen Davis-Wheatman, attorney-in-fact for Kevin Douglas 01/31/2012
/s/ Eileen Davis-Wheatman, attorney-in-fact for Douglas Family Trust 01/31/2012
/s/ Eileen Davis-Wheatman, attorney-in-fact for James Douglas and Jean Douglas Irrevocable Descendants? Trust 01/31/2012
/s/ Eileen Davis-Wheatman, attorney-in-fact for James E. Douglas III 01/31/2012
** 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).
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