-----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, Foj6recDCnfD3FHTaMh+hZMYemHgg3p/d1I2iSIYo36308fGKtYb1z4GBt6UP5TQ 2lYLlYxHcE6QO8F7TtEnMg== 0001042910-99-001811.txt : 19991223 0001042910-99-001811.hdr.sgml : 19991223 ACCESSION NUMBER: 0001042910-99-001811 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19991213 FILED AS OF DATE: 19991222 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HEALTH EXPRESS USA INC CENTRAL INDEX KEY: 0001070050 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-EATING PLACES [5812] IRS NUMBER: 650847995 STATE OF INCORPORATION: FL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-27569 FILM NUMBER: 99778963 BUSINESS ADDRESS: STREET 1: 275 COMMERCIAL BLVD STREET 2: SUITE 260 CITY: FT LAUDERDALE STATE: FL ZIP: 33308 BUSINESS PHONE: 9547765401 MAIL ADDRESS: STREET 1: 275 COMMERCIAL BOULEVARD STREET 2: SUITE 260 CITY: FORT LAUDERDALE STATE: FL ZIP: 33308 COMPANY DATA: COMPANY CONFORMED NAME: MALTROTTI DAVID CENTRAL INDEX KEY: 0001101413 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 275 COMMERCIAL BLVD STREET 2: SUITE 260 CITY: FT LAUDERDALE STATE: FL ZIP: 33308 MAIL ADDRESS: STREET 1: 275 COMMERCIAL BLVD STREET 2: SUITE 260 CITY: FT LAUDERDALE STATE: FL ZIP: 33308 3 1 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES : U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 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 Maltrotti David - -------------------------------------------------------------------------------- (Last) (First) (Middle) 275 Commercial Blvd. Suite 260 - -------------------------------------------------------------------------------- Ft. Lauderdale FL 33308 - -------------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 12/13/99 - -------------------------------------------------------------------------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) - -------------------------------------------------------------------------------- 4. Issuer Name or Ticker or Trading Symbol Health Express USA, Inc. - -------------------------------------------------------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Executive Vice President - -------------------------------------------------------------------------------- 1 6. If Amendment, Date of Original (Month/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 - -------------------------------------------------------------------------------- Table I -- Non-Derivative Securities Beneficially Owned - --------------------------------------------------------------------------------
3. Ownership Form 2. Amount of Securities direct (D) or 1. Title of Security Beneficially Owned Indirect (I) (Instr. 4) (Instr. 4) (Instr. 5) - -------------------------------------------------------------------------------------------------------- - -------------------------------------------------------------------------------------------------------- Common Stock 18,500 D - --------------------------------------------------------------------------------------------------------
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. 2 Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------- 3. Title and Amount of Securities Underlying Derivative Security 2. Date Exercisable (Instr. 4) and Expiration Date (Month/Day/Year) Amount or Date Expira- Number 1. Title of Derivative Exer- tion of Security (Instr. 4) cisable Date Title Shares - ------------------------------------------------------------------------------------------------------------------- Stock Option 2/3/99 12/31/01 Common Stock 100,000 - ------------------------------------------------------------------------------------------------------------------- Stock Option 2/3/00 12/31/01 Common Stock 100,000 - -------------------------------------------------------------------------------------------------------------------
Explanation of Responses: An option for 200,000 shares was granted pursuant to an employment agreement dated February 3, 1999. Of said amount, 50,000 vest in year one at an exercise price of $.75 per share, 50,000 vest in year one at an exercise price of $1.00 per share, 50,000 vest in year two at an exercise price of $1.25 per share and 50,000 vest in year two at an exercise price of $1.50 per share. The options expire on the earlier of (i) exercise of all options, (ii) he is no longer employed by Issuer, or (iii) December 31, 2001. By: /s/ David Maltrotti December 21, 1999 -------------------------------------- ----------------- **Signature of Reporting Person Date Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 19 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. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. 3 -----END PRIVACY-ENHANCED MESSAGE-----