4 1 p65505e4.htm FORM 4 e4

FORM 4

U.S. SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, DC 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

     
Check box if no longer subject to
Section 16. Form 4 or Form 5 obligations may
continue. See Instruction 1(b).

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility
Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940


         
1.   Name and Address of Reporting Person* 2.   Issuer Name and Ticker or Trading Symbol 6.   Relationship of Reporting Person
National Scientific Corporation     NSCT to Issuer (Check all applicable)


(X BOX) Director (BOX) 10% Owner
(Last)               (First)               (Middle) 3.   IRS Identification Number of Reporting Person, if an Entity (Voluntary) (X BOX) Officer (give title below)
Grollman           Michael             A 86-0837077 (BOX) Other (specify below)
                President



(Street) 4.   Statement for Month/Year 7.   Individual or Joint/Group Filing
4455 East Camelback Road Ste E-160] 8/2001 (Check applicable line)


(X BOX) Form Filed by One Reporting Person
(City)                  (State)                  (Zip) 5.   If Amendment, Date of Original (Month/Year) (BOX) Form Filed by More than One
Reporting Person
[Phoenix       AZ      85018



TABLE I — NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED


                         
4.   Securities Acquired (A)
3.   Transaction Code or Disposed of (D)
2.  Transaction Date (Instr. 8) (Instr. 3, 4 and 5)



(A)
or
1.   Title of Security (Instr. 3) (Month/Day/Year) Code V Amount (D) Price







NSCT Common Stock 8/21/2001 P V 5000 A 0.48
   
   
   

[Additional columns below]

[Continued from above table]
         
5.   Amount of 6.   Ownership Form:
Securities Beneficially Direct (D) or 7.   Nature of Indirect
Owned at End of Month Indirect (I) Beneficial Ownership
(Instr. 3 and 4) (Instr. 4) (Instr. 4)



121,035 D  
 
 
 

Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.

(Print or Type Responses)                                                          (Over)
*If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v).


FORM 4 (CONTINUED)

TABLE II — DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)


                         
5. Number of
Derivative
Securities
Acquired (A) or
4. Transaction Disposed of (D)
Code (Instr. 3, 4,
2. Conversion or (Instr. 8) and 5)
1. Title of Derivative Exercise Price of 3. Transaction Date

Security (Instr. 3) Derivative Security (Month/Day/Year) Code V (A) (D)







   
   
   
   
   
   
   
   
   

[Additional columns below]

[Continued from above table]
                 
6. Date Exercisable 7. Title and Amount
and Expiration of Underlying
Date (Month/Day/ Securities
Year) (Instr. 3 and 4)


8. Price of
Amount or Derivative
Date Expiration Number of Security
Exercisable Date Title Shares (Instr. 5)





     
     
     

         
9. Number of 10. Ownership
Derivative Form of
Securities Derivative 11. Nature of
Beneficially Security: Indirect
Owned at End Direct (D) Beneficial
of Month or Indirect (I) Ownership
(Instr. 4) (Instr. 4) (Instr. 4)



     
     
     

      Explanation of Responses:

     
/s/ Michael A. Grollman [8/21/2001]


**Signature of Reporting Person Date

     **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 provided is insufficient, see Instruction 6 for procedure.

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