EX-3 5 f55b.htm INSIDER REPORT - GEORGE KENNEDY FORM 55-102F6

FORM 55-102F6

      

INSIDER REPORT

      
        

Box 1. Name of the Reporting Issuer (Block Letters)

  

 

    

 

  

MICROMEM TECHNOLOGIES INC.

 

 

  

 

 

 

 

 

 

  
        
        
        

Box 2.  Insider Data

 

 

 

 

 

 

 

     

 

 

Relationship(s) to Reporting Issuer

Date of Last Report Filed

 

4

 

 

or

5

3

2001

 

 

   

Day

Month

Year

 

Change in Relationship From Last Report

 

If Initial Report, Date on Which you Became an Insider

 

 

 

No

 

 

 

 

 

 

 

 

 

Day

Month

Year

 
        


         

 

Box 3. Name, Address and Telephone Number of the Insider (Block Letters)

 

 

 

      

 

 

 

Family Name or Corporate Name

   

 

 

 

KENNEDY

 

 

 

 

 

 

 

 

Given Names

     

 

 

 

GEORGE

 

 

 

 

 

 

 

 

No.

  

Street

 

Apt.

 

 

 

8103 HIGHLAND MEADOWS DRIVE

 

 

 

 

 

 

City

     

 

 

 

CLINTON

 

 

 

 

 

 

 

 

Prov.

   

Postal Code

 

 

 

 

MARYLAND 

 

 USA

 

20735

 

 

 

 

Busin-ess Telephone Number

  

Change in Name, Address or Telephone Number from last report

 

 

 

 

301-856-5802

 

 

 

 

 

 

Business Fax Number

  

NO

 

 

 

301-856-1854

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 
         


       

 

Box 4. Jurisdiction(s) where the issuer is a

 

 

 

reporting issuer or the equivalent

 

 

X

Alberta

X

Ontario

 

 

     

 

 

 

British Columbia

 

Quebec

 

 

     

 

 

X

Manitoba

 

Saskatchewan

 

 

     

 

 

 

Newfoundland

  

 

 

     

 

 

 

Nova Scotia

  

 

 

 

 

 

 

 

 

       


Box 5. Insider Holdings and Changes (if initial report, complete 

           

A

B

  

C

   

D

E

F

    

Transactions

      
          

         

Direct/Indirect

  

Designation of Class of Securities

Balance of Class of Securities on Last

Report

 

Date

(Day/Month/Year)

 

 Nature

 

Number/Value

Acquired

 

Number/Value

Disposed of

Unit

Price/Exercise

Price

  

USD

Present Balance

of Class of

Securities Held

Ownership/

Control or

Direction

Indentify the Registered
Holder where ownership
is indirect or where

control or direction is

exercised

common share options

500,000

30/06/2002

 52

 

250,000

7.06

x

250,000

1

 

        
           
           
           
           
           
           
           
           
           
           
           


Attachment

 

Box 6. Remarks

    
 

No

     
       
  

The undersigned certifies that the information given in this report is true and complete in every respect. It is an offence to submit information that, in a material respect and at the time and in light of the circumstances in which it is submitted, is misleading or untrue.

  

Correspondence

   

x

 

Box 7. Signature

    

English

French

Name (block letters) GEORGE KENNEDY

Signature

"signed"

Date of the Report (Day/Month/Year)

13/1/2003