0000921895-12-002057.txt : 20121018 0000921895-12-002057.hdr.sgml : 20121018 20121018150832 ACCESSION NUMBER: 0000921895-12-002057 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121016 FILED AS OF DATE: 20121018 DATE AS OF CHANGE: 20121018 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: CHISTE JOHN F CENTRAL INDEX KEY: 0001217918 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-34780 FILM NUMBER: 121150387 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: FORWARD INDUSTRIES INC CENTRAL INDEX KEY: 0000038264 STANDARD INDUSTRIAL CLASSIFICATION: PLASTICS PRODUCTS, NEC [3089] IRS NUMBER: 131950672 STATE OF INCORPORATION: NY FISCAL YEAR END: 0930 BUSINESS ADDRESS: STREET 1: 1801 GREEN ROAD STREET 2: SUITE E CITY: POMPANO BEACH STATE: FL ZIP: 33064 BUSINESS PHONE: 9544199544 MAIL ADDRESS: STREET 1: 1801 GREEN RD STREET 2: SUITE E CITY: POMPANO BEACH STATE: FL ZIP: 33064 FORMER COMPANY: FORMER CONFORMED NAME: PROGRESS HEAT SEALING CO INC DATE OF NAME CHANGE: 19721111 4 1 form4a08126007_10182012.xml OWNERSHIP DOCUMENT X0306 4 2012-10-16 0 0000038264 FORWARD INDUSTRIES INC FORD 0001217918 CHISTE JOHN F C/O FORWARD INDUSTRIES, INC. 477 ROSEMARY AVE., SUITE 217-219 WEST PALM BEACH FL 33410 1 0 0 0 Stock Option (Right to Buy) 1.23 2012-10-16 4 A 0 10000 0 A 2013-10-16 2022-10-15 Common Stock, $0.01 par value 10000 30000 D The exercise price is equal to the closing price of the stock on the date of grant. This amount includes options to purchase 20,000 shares of Common Stock which were previously granted. JAMES MCKENNA BY POWER OF ATTORNEY 2012-10-18