-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, DK3YFznvR6nkAwechQvIV9ZrJoC0kfv7oB0Vf0H9Onm01G6o1Yy30YGLwQyZXgXd X02G/h+J+3G6Hp7d0Ww9Bg== 0001025894-02-000730.txt : 20021107 0001025894-02-000730.hdr.sgml : 20021107 20021107134632 ACCESSION NUMBER: 0001025894-02-000730 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021104 FILED AS OF DATE: 20021107 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: GRANT PATRICK CENTRAL INDEX KEY: 0001204262 RELATIONSHIP: OFFICER FILING VALUES: FORM TYPE: 4 MAIL ADDRESS: STREET 1: 1020 10TH STREET CITY: CHARLESTON STATE: IL ZIP: 81920 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FLEXIBLE SOLUTIONS INTERNATIONAL INC CENTRAL INDEX KEY: 0001069394 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS CHEMICAL PRODUCTS [2890] IRS NUMBER: 911922863 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-29649 FILM NUMBER: 02812288 BUSINESS ADDRESS: STREET 1: 2614 QUEENSWOOD DR CITY: VICTORIA B C V8N 1X5 STATE: A1 BUSINESS PHONE: 2504779969 MAIL ADDRESS: STREET 1: 2614 QUEENSWOOD DR CITY: VICTORIA BC CANADA STATE: A1 4 1 fs_grant4.txt FORM 4 FORM 4 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, 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* Patrick Grant 1020 10th Street Charleston, IL 61920 2. Date of Event Requiring Statement (Month/Day/Year) 11/4/2002 3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) 4. Issuer Name and Ticker or Trading Symbol Flexible Solutions International, Inc. (FXSO) 5. Relationship of Reporting Person(s) to Issuer (Check All Applicable) / / Director /X/ Officer (give title below) President Water$avr Global Solutions, Inc., wholly-owned subsidiary / / 10% Owner / / Other (specify below) 6. If Amendment, Date of Original (Month/Day/Year) N/A 7. Individual or Joint/Group Filing (Check Applicable Line) /X/ Form filed by One Reporting Person / / Form filed by More than One Reporting Person 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). Table 1 -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned 1. Title of Security (Instr. 3) Common Stock 2. Transaction Date(s) (Month/Day/Year) 11-4-02 3. Transaction Code (Instr. 8) S 4. Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) Date Amount(Shares) (A) or (D) Price per share --------- -------------- ---------- --------------- 11/ 4/02 15,000 D 3.31 5. Amount of Securities Beneficially Owned at End of Month (Instr. 3 and 4) 45,000 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) D 7. Nature of Indirect Beneficial Ownership (Instr. 4) N/A 2 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).
Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exercisable 3. Title and Amount of 4. Converstion 5. Ownership 6. Nature of Security (Instr. 4) and Expiration Date Securities or Form of Indirect (Month/Day/Year) Underlying Exercise Derivative Beneficial Derivative Security Price of Security: Ownership (Instr. 4) Derivative Direct (D) (Instr. 5) Security or Indirect (I) (Instr. 5) ------------------------ ------------------------ Date Expiration Title Amount Exercisable Date or Number of Shares - ----------------------------- ------------ ----------- ------------- ---------- --------------- --------------- -------------- Employee Stock Option 12/31/01 12/31/06 Common Stock 100,000 1.50 D Employee Stock Option 6/30/02 6/30/07 Common Stock 100,000 1.50 D Employee Stock Option 12/31/02 12/31/07 Common Stock 100,000 2.00 D Employee Stock Option 6/30/03 6/30/08 Common Stock 100,000 2.00 D Employee Stock Option 12/31/03 12/31/08 Common Stock 100,000 2.50 D Employee Stock Option 6/30/04 6/30/09 Common Stock 100,000 2.50 D Employee Stock Option 12/31/04 12/31/09 Common Stock 100,000 3.00 D Employee Stock Option 6/30/05 6/30/10 Common Stock 100,000 3.00 D Employee Stock Option 12/31/05 12/31/10 Common Stock 100,000 3.50 D Employee Stock Option 6/30/06 6/30/11 Common Stock 100,000 3.50 D - ----------------------------- ------------ ----------- ------------- ---------- --------------- --------------- --------------
Explanation of Responses: All options were granted 7-1-2001 /s/ PATRICK GRANT 11/4/02 --------------------------------------- --------- Patrick Grant ** 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).
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