0001005477-01-501285.txt : 20011010 0001005477-01-501285.hdr.sgml : 20011010 ACCESSION NUMBER: 0001005477-01-501285 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010901 FILED AS OF DATE: 20011009 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: DAG MEDIA INC CENTRAL INDEX KEY: 0001080340 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS PUBLISHING [2741] IRS NUMBER: 113474831 STATE OF INCORPORATION: NY FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25991 FILM NUMBER: 1755272 BUSINESS ADDRESS: STREET 1: 125 QUEENS BLVD., SUITE 14 CITY: KEW GARDENS STATE: NY ZIP: 11415 MAIL ADDRESS: STREET 1: 125 QUEENS BLVD., SUITE 14 CITY: KEW GARDENS STATE: NY ZIP: 11415 COMPANY DATA: COMPANY CONFORMED NAME: RAN ASSAF CENTRAL INDEX KEY: 0001084777 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O DAG MEDIA INC STREET 2: 125-10 QUEENS BOULEVARD CITY: KEN GARDENS STATE: NY ZIP: 11415 BUSINESS PHONE: 7182638454 MAIL ADDRESS: STREET 1: C/O DAG MEDIA INC STREET 2: 125-10 QUEENS BOULEVARD CITY: KEN GARDENS STATE: NY ZIP: 11415 4 1 d01-33787.txt FORM 4 FORM 4 -------------------------- OMB APPROVAL -------------------------- OMB Number 3235-0287 Expires: December 31, 2001 Estimated average burden hours per response.....0.5 -------------------------- U.S. SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 |_| Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ================================================================================ 1. Name and Address of Reporting Person* Ran Assaf -------------------------------------------------------------------------------- (Last) (First) (Middle) c/o DAG Media 125-10 Queens Blvd. -------------------------------------------------------------------------------- (Street) Kew Gardens NY 11415 -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol DAG Media, Inc. "DAGM" ================================================================================ 3. IRS Identification Number of Reporting Person, if an Entity (Voluntary) ================================================================================ 4. Statement for Month/Year 9/01 ================================================================================ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) |X| Director |X| 10% Owner |X| Officer (give title below) |_| Other (specify below) ================================================================================ 7. Individual or Joint/Group Filing (Check Applicable Line) |X| Form filed by one Reporting Person |_| Form filed by more than one Reporting Person ================================================================================ * If the Form is filed by more than one Reporting Person, see Instruction 4(b)(v). ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ---------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ Common Stock, par value $.001 per share 9/21/01 P 5000 A $1.05 1,419,095 D ------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) SEC 1474 (7-96) ---------------- (1) 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) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- Form of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature of Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 5) 5) ------------------------------------------------------------------------------------------------------------------------------------ ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ----------------------------------------------------------------------------------------------------------------------------------- ===================================================================================================================================
Explanation of Responses: ** 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. 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 Member /s/ Assaf Ran 10/9/01 --------------------------------------------- ---------- ** Signature of Reporting Person Date