5 1 form5nesrsta.htm FORM 5 NESRSTA ENDING 12/31/2002 Form 5

FORM 5

 

UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549

ANNUAL 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(h) of the Investment Company Act of 1940

  


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[   ] 

Check this box if no longer subject to
Section 16. Form 4 or Form 5 obli-
gations may continue. See Instruc-
tion 1(b).

 

  

[   ] 

Form 3 Holdings Reported

 

[   ] 

Form 4 Transactions Reported

 

 

1. Name and Address of Reporting Person*          


Nesrsta, Paul

 

2. Issuer Name and Ticker or Trading Symbol

Reliability Incorporated (REAL)

 

6. Relationship of Reporting Person(s) to Issuer
                  (Check all applicable)

 

Director

 

10% Owner

 x

Officer (give
title below)

 

Other (specify
below)

Vice President 

(Last)                    (First)                (Middle)


2727 West Hedgecroft

 

3. I.R.S. Identification
   Number of Reporting
   Person, if an entity
   (Voluntary)

 

4. Statement for Month/Year

December 2002 


7. Individual or Joint/Group Reporting
              (check applicable line)

5. If Amendment, Date of
    Original (Month/Year)

 

 x  

Form Filed by One Reporting Person

(Street)
Seabrook, TX 77586

 

   

Form Filed by More than One Reporting Person

(City)                      (State)                  (Zip)

Table I ¾  Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
    (Instr. 3)

 

2. Trans-
    action
    Date
   (Month/
    Day/
   Year)

2A. Deemed
      Execu-
      tion
      Date, if
      any
     (Month/
      Day/
      Year)

3. Trans-
    action
    Code
    (Instr.8)

4. Securities Acquired (A) or
    Disposed of (D)
    (Instr. 3, 4 and 5)

5. Amount of
    Securities Ben-
    eficially Owned
    at end of
    Issuer's Fiscal
    Year
    (Instr. 3 and 4)

6. Owner-
    ship
    Form: Di-
    rect (D)
    or Indi-
    rect (I)
    (Instr. 4)

7. Nature of
    Indirect
    Beneficial
    Ownership
   (Instr. 4)

Amount

  (A) or
  (D)

Price

 Reliability Incorporated Common Stock

 

 

 

 

 

 

 27,000

D

 

Common Stock

 

 

 

 

 

 

18,287 (1)

I (by 401(k))

 

 (1) includes a net 1,636 shares acquired between January 1, 2002 and December 31, 2002 under the Reliability Incorporated 401(k) Plan

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

*

If the form is filed by more than one reporting person, see instruction 4(b)(v).             

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(Over)
SEC2270 (9-02)

 

 

 

FORM 5 (continued)

Table II ¾  Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative
    Security (Instr. 3)

 

2. Conver-
    sion or
    Exercise
    Price of
    Deriva-
    tive Sec-
    urity

 

3. Trans
    -action
    Date
   (Month/
    Day/
    Year)

3A. Deem
      -ed Ex-
      ecution
      Date, if
      any
     (Month/
       Day/
       Year)

 

4. Trans-
    action
    Code
    (Instr.8)

5. Number of Deriva-
    tive Securities Ac-
    quired (A) or Dis-
    posed of (D)
    (Instr. 3, 4 and 5)

6. Date Exercis-
    able and Expi-
    ration Date
    (Month/Day/
     Year)

7. Title and Amount of Underly-
    ing Securities
    (Instr. 3 and 4)

8. Price
    of
    De-
    riva-
    tive
    Secu-
    rity
 (Instr. 5)

9. Number
   of De-
   rivative
   Securi-
   ties Ben-
   eficially
   Owned
   at End of
   Year
   (Instr. 4)

10. Owner-
      ship of
      Deriva-
      tive Se-
      curity:
      Direct
      (D) or
      Indirect
      (I)
      (Instr. 4)

 

11. Nature of
     Indirect
     Benefi-
     cial
     Owner-
     ship
     (Instr. 4)

 

(A)

(D)

  Date
  Exer-
  cisable

  Expira-
  tion
  Date

Title

 Amount or
 Number of
 Shares

Reliability Inc Option to purchase Common Stock

$13.38

11/13/02

 

J (1)

 

800

3/30/99

2/24/08

Common

800

 

 

 

 

$13.38

11/13/02

 

J(1)

 

14,200

3/30/99

2/24/08

Common

14,200

 

 

 

 

  "

$3.50

3/1/02

 

J (2)

 

3,000

9/1/97

3/1/02

Common

3,000

 

75,000

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

 (1) Cancellation of options

 

(2) Expiration of options

 

 

 

/s/ Paul Nesrsta 

          

February 4, 2003

**

Intentional misstatements or omissions of facts constitute Federal Criminal Violations.

**Signature of Reporting Person

          

Date

 

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.

 

     

 

 

 

 

     

 

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SEC2270 (9-02)