-----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, MP/hxNgjtwWV9tlPTvh4CHfX9k+4Bm5hTaJrZnE3J0BFh+HNGDVWGzeDcSEyZi3w NqjVVF5AZwtvF6arMyddUw== 0000950147-00-000272.txt : 20000221 0000950147-00-000272.hdr.sgml : 20000221 ACCESSION NUMBER: 0000950147-00-000272 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000126 FILED AS OF DATE: 20000218 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: FRONTIER ADJUSTERS OF AMERICA INC CENTRAL INDEX KEY: 0000735349 STANDARD INDUSTRIAL CLASSIFICATION: PATENT OWNERS & LESSORS [6794] IRS NUMBER: 860477573 STATE OF INCORPORATION: AZ FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 001-12902 FILM NUMBER: 549494 BUSINESS ADDRESS: STREET 1: 45 E MONTEREY WAY STREET 2: STE 202 CITY: PHOENIX STATE: AZ ZIP: 85011 BUSINESS PHONE: 6022641061 MAIL ADDRESS: STREET 1: P O BOX 7610 CITY: PHOENIX STATE: AZ ZIP: 85011 FORMER COMPANY: FORMER CONFORMED NAME: FRONTIER FINANCIAL CORP /AZ DATE OF NAME CHANGE: 19861114 COMPANY DATA: COMPANY CONFORMED NAME: CAVALLARO PETER CENTRAL INDEX KEY: 0001107015 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O IMPERIAL FINANCIAL PRINTING STREET 2: 210 S FOURTH AVE CITY: PHOENIX STATE: AZ ZIP: 85003 MAIL ADDRESS: STREET 1: IMPERIAL FINANCIAL PRINTING STREET 2: 210 S FOURTH AVE CITY: PHOENIX STATE: AZ ZIP: 85003 3 1 FORM 3 FOR PETER CAVALLARO ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0104 Expires: September 30, 1998 Estimated average burden hours per response ....... 0.5 ------------------------------ ------ FORM 3 U.S. SECURITIES AND EXCHANGE COMMISSION ------ Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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(f) of the Investment Company Act of 1940 ================================================================================ 1. Name and Address of Reporting Person Cavallaro Peter - -------------------------------------------------------------------------------- (Last) (First) (Middle) Netrex 270 South Service Road, Suite 45 - -------------------------------------------------------------------------------- (Street) Melville NY 11747 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) January 26, 2000 ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ================================================================================ 4. Issuer Name and Ticker or Trading Symbol Frontier Adjusters of America, Inc. (FAJ) ================================================================================ 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ ] 10% Owner [X] Officer (give title below) [ ] Other (specify below) Secretary -------------------------------------------------------------------- ================================================================================ 6. If Amendment, Date of Original (Month/Year) ================================================================================ 7. Individual or Joint/Group Filling (Check Applicable Line) [X] Form filed by One Reporting Person [ ] Form filed by More than One Reporting Person ================================================================================ FORM 3 (continued) ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================ 3. Ownership Form: 1. Title of 2. Amount of Securities Direct (D) or 4. Nature of Indirect Security Beneficially Owned Indirect (I) Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr.5) - -------------------------------------------------------------------------------- No securities owned. - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- ================================================================================ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
========================================================================================================= 3. Title and Amount 5. Owner- of Securities Underlying ship Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date ------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 6. Nature of 1. Title of ---------------------- or Exercise (D) or Indirect Derivative Date Expira- Number Price of Indirect Beneficial Security Exer- tion of Derivative (I) Ownership (Instr. 4) cisable Date Title Shares Security (Instr.5) (Instr. 5) - - --------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------- - --------------------------------------------------------------------------------------------------------- =========================================================================================================
Explanation of Responses: /s/ Peter Cavallaro February 17, 2000 - --------------------------------------------- ----------------------- Peter Cavallaro Date **Signature of Reporting Person ** Intentional misstatements or omissions of facts constitute 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 provided is insufficient. See Instruction 6 for procedure. -----END PRIVACY-ENHANCED MESSAGE-----