-----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, Melv0uXW+DnZDa7JGGwM8+ymOH2OYTKBv1LaPss9xxBjpSIfqIVEFkaK9VsC7Rs/ dWVEozy8Gpn5Df44sJmbhQ== 0000912057-01-514310.txt : 20010511 0000912057-01-514310.hdr.sgml : 20010511 ACCESSION NUMBER: 0000912057-01-514310 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20010430 FILED AS OF DATE: 20010510 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BILLSERV COM INC CENTRAL INDEX KEY: 0001088034 STANDARD INDUSTRIAL CLASSIFICATION: FUNCTIONS RELATED TO DEPOSITORY BANKING, NEC [6099] IRS NUMBER: 980190072 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 000-30152 FILM NUMBER: 1628398 BUSINESS ADDRESS: STREET 1: 211 N LOOP 1604 STREET 2: SUITE 100 CITY: SAN ANTONIO STATE: TX ZIP: 78232 BUSINESS PHONE: 2104025000 MAIL ADDRESS: STREET 1: 211 N LOOP 1604 STREET 2: STE 100 CITY: SAN ANTONIO STATE: TX ZIP: 78232 COMPANY DATA: COMPANY CONFORMED NAME: JONES DAVID S CENTRAL INDEX KEY: 0001089347 STANDARD INDUSTRIAL CLASSIFICATION: [] DIRECTOR FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 211 N LOOP STREET 2: 1604 E. SUITE 100 CITY: SAN ANTONIO STATE: TX ZIP: 78232 MAIL ADDRESS: STREET 1: 211 N., LOOP STREET 2: 1604 E. SUITE 100 CITY: SAN ANTONIO STATE: TX ZIP: 78232 4 1 a2048792z4.txt FORM 4
- -------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION ----------------------------- FORM 4 WASHINGTON, D.C. 20549 OMB APPROVAL - -------- ----------------------------- / / CHECK THIS BOX IF NO STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OMB NUMBER: 3235-0287 LONGER SUBJECT TO EXPIRES: SEPTEMBER 30, 1998 SECTION 16. FORM 4 OR Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, ESTIMATED AVERAGE BURDEN FORM 5 OBLIGATIONS MAY Section 17(a) of the Public Utility Holding Company Act of 1935 or HOURS PER RESPONSE .... 0.5 CONTINUE. SEE Section 30(f) of the Investment Company Act of 1940 ----------------------------- INSTRUCTION 1(b). (Print or Type Responses) - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person* 2. Issuer Name AND Ticker or Trading Symbol 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Jones David S. billserv.com, Inc. BLLS ---- ---- - --------------------------------------------------------------------------------------------- X Officer (give Other (Last) (First) (Middle) 3. IRS or Social Security 4. Statement for ---- title ---- (specify Number of Reporting Month/Year below) below Person (Voluntary) ----------------- ------------------ 211 N. Loop 1604 E., Ste. 100 April 2001 - -------------------------------------------- --------------------- 7. Individual or Joint/Group Filing (Street) 5. If Amendment, (Check Applicable Line) Date of Original X Form filed by One Reporting Person (Month/Year) --- Form filed by More than One San Antonio TX 78232 ---Reporting Person - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) TABLE I - NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature (Instr. 3) action action or Disposed of (D) Securities ship of In- Date Code (Instr. 3, 4 and 5) Beneficially Form: direct (Instr. 8) Owned at Direct Bene- (Month/ End of (D) or ficial Day/ ------------------------------------------- Month Indirect Owner- Year) (A) or (I) ship Code V Amount (D) Price (Instr. 3 (Instr. 4) (Instr. 4) and 4) - ------------------------------------------------------------------------------------------------------------------------------------ Common 4/16/01 S 3,700 D $2.160 - ------------------------------------------------------------------------------------------------------------------------------------ 4/18/01 S 6,000 D $2.243 - ------------------------------------------------------------------------------------------------------------------------------------ 4/18/01 S 6,300 D $2.219 - ------------------------------------------------------------------------------------------------------------------------------------ 4/19/01 S 2,000 D $2.45 - ------------------------------------------------------------------------------------------------------------------------------------ 4/19/01 S 1,000 D $2.45 - ------------------------------------------------------------------------------------------------------------------------------------ 4/19/01 S 1,000 D $2.45 1,125,483 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over) * If the form is filed by more than one reporting person, SEE Instruction 4(b)(v). SEC 1474 (7-97) 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 CONTROL NUMBER.
FORM 4 (CONTINUED) TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - ------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv- 6. Date Exer- (Instr. 3) sion or action tion Code ative Securities Ac- cisable and Ex- Exercise Date (Instr. 8) quired (A) or Dis- piration Date Price of (Month/ posed of (D) (Month/Day/ Deriv- Day/ (Instr. 3, 4, and 5) Year) ative Year) Security -------------------- Date Expira- -------------------------------------- Exer- tion cisable Date Code V (A) (D) - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ 7. Title and Amount of Under- 8. Price 9. Number 10. Owner- 11. Nature lying Securities of of Deriv- ship of In- (Instr. 3 and 4) Deriv- ative Form direct ative Securi- of De- Bene- Secur- ties rivative ficial ity Bene- Secu- Own- (Instr. ficially rity: ership 5) Owned Direct (Instr. 4) at End (D) or Amount or of Indi- Title Number of Month rect (I) Shares (Instr. 4) (Instr. 4) - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------ Explanation of Responses: Third-party sale under Rule 144(k) /s/ David S. Jones 5/9/01 ----------------------------------- ----------- **Intentional misstatements or omissions of facts constitute **Signature of Reporting Person Date 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 Number. Page 2 SEC 1474 (7-97)
-----END PRIVACY-ENHANCED MESSAGE-----