3 1 fish.txt EDWARD FISHMAN
- ------------------ U.S. SECURITIES AND EXCHANGE COMMISSION |--------------------------| | F O R M 3 | Washington, D.C. 20549 | OMB APPROVAL | - ------------------ |--------------------------| INITIAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP |OMB Number 3235-0104| |Expires: January 31, 2005| Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, |Estimated avg. burden | Section 17(a) of the Public Utility Holding Company Act of 1935 or |hours per response.....0.5| Section 30(f) of the Investment Company Act 1940 ---------------------------- - ---------------------------------------------------------------------------------------------------------------------------------- |1.Name and Address of Reporting Person* |2.Date of Event |4.Issuer Name and Ticker or Trading Symbol | | | Requiring Statement | | | | (Month/Day/Year) | LaserLock Technologies, Inc. (LLTI) | | Fishman Edward J | | | |----------------------------------------| 12/21/01 |-----------------------------------------------------------------| | (Last) (First) (MI)| |5.Relationship of Reporting Person to |6.If Amendment, Date of | | | | Issuer (Check all Applicable) | Original (Mon/Day/Year)| | | | | | | |-----------------------| X Director 10% Owner | | | 711 S. Carson #4 |3.IRS Identification |--- --- |-------------------------| |----------------------------------------| Number of Reporting | |7.Individual or Joint/ | | (Street) | Person, if an entity | Officer (give Other | Group Filing | | | (voluntary) |--- title --- (specify | (Check Applicable Line)| | | | below) below) | X Form filed by One | | | | |--- Reporting Person | | | | | Form filed by More | | | -- | Vice Chairman of the | than One Reporting | | Carson City NV 89701 | | Board of Directors |--- Person | |----------------------------------------|-----------------------------------------------------------------------------------------| | (City) (State) (Zip) | | | | TABLE I - Non-Derivative Securities Beneficially Owned | |----------------------------------------------------------------------------------------------------------------------------------| |1.Title of Security (Instr. 4) |2.Amount of Securities |3.Ownership |4.Nature of Indirect Beneficial | | | Beneficially Owned | Form: | Ownership (Instr. 5) | | | (Instr. 4) | Direct (D) | | | | | or Indirect | | | | | (I)(Instr.5)| | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | Common Stock | 500,000 | D | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | |------------------------------------------|-----------------------------|--------------|------------------------------------------| | | | | | | | | | | - ---------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class securities owned directly or indirectly. *If the form is filed by more than one reporting person, see Instruction 5(b)(v). PAGE: 1 OF 2
FORM 3 (continued) TABLE II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - ---------------------------------------------------------------------------------------------------------------------------------- |1.Title of |2.Date Exercisable and |3.Title and Amount of Underlying |4.Conversion or |5. |6.Nature of | | Derivative | Expiration Date | Derivative Security (Instr. 4) | Exercise Price |Own. | Indirect | | Security | (Month/Day/Year) | | of Derivative |Form | Beneficial | | (Instr. 4) | | | Security |of | Ownership | | | | | |Deri.| (Instr. 5) | | | | | |Sec. | | | | | | |Dir. | | | | | | |(D) | | | |-----------------------------|--------------------------------------| |or | | | |Date |Expiration | |Amount or Number | |Ind. | | | |Exercisable |Date | Title |of Shares | |(I) | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | (1) | 12/21/04 | Common Stock | 500,000 | $330,000(1) | D | | |Stock Option to | | | | | | | | |Purchase Shares of | | | | | | | | |Common Stock | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | |-------------------|--------------|--------------|-------------------|------------------|-------------------|-----|---------------| | | | | | | | | | | | | | | | | | | - --------------------------------------------------------------------------------------------------------------------------------- Explanation of Responses: (1) 250,000 options at $.42 per share vests as follows: - 62,500 six months from the anniversary of the date of grant - 62,500 twelve months from the anniversary of the date of grant - 125,000 eighteen months from the anniversary of the date of grant 250,000 options priced and vested as follows: - 62,500 twelve months from the anniversary of the date of grant at $.75 - 62,500 eighteen months from the anniversary of the date of grant at $.85 - 125,000 twenty-four months from the anniversary of the date of grant at $1.00. **Intentional misstatements or omissions of facts constitute Federal /s/ Edward J. Fishman December 24, 2001 Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). ---------------------------------- ----------------- **Signature of Reporting Person Date Note: File three copies of this form, one of which must be manually signed. Edward J. Fishman 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 OMD Number. PAGE: 2 OF 2