-----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, L5UXT7on3GceoHz0svM8uAOj0lMW07wktPIbPU3jLdagFQzQ+DJNweww8P/AQrny 9WwusTy7WG2imq4WY/TxaQ== 0000950147-01-500034.txt : 20010122 0000950147-01-500034.hdr.sgml : 20010122 ACCESSION NUMBER: 0000950147-01-500034 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001123 FILED AS OF DATE: 20010104 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: 1501884 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: NETREX HOLDINGS LLC CENTRAL INDEX KEY: 0001131142 STANDARD INDUSTRIAL CLASSIFICATION: [] OWNER STATE OF INCORPORATION: DE FISCAL YEAR END: 0930 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 7100 EAST LINCOLN DRIVE STREET 2: SUITE D-230 CITY: SCOTTSDALE STATE: AZ ZIP: 85253 MAIL ADDRESS: STREET 1: 7100 EAST LINCOLN DRIVE STREET 2: SUITE D-230 CITY: SCOTTSDALE STATE: AZ ZIP: 85253 3 1 e-5990.txt FORM 3 FOR NETREX HOLDINGS, L.L.C. ------------------------------ OMB APPROVAL ------------------------------ ------ OMB Number 3235-0104 FORM 3 Expires: December 31, 2001 ------ Estimated average burden hours per response ....... 0.5 ------------------------------ 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 Netrex Holdings, L.L.C., a Delaware limted liability company - -------------------------------------------------------------------------------- (Last) (First) (Middle) 270 South Service Road, Suite 45 - -------------------------------------------------------------------------------- (Street) Melville New York 11747-2339 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) November 23, 1999 ================================================================================ 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 [X] 10% Owner (1) [ ] Officer (give title below) [ ] Other (specify below) -------------------------------- ================================================================================ 6. If Amendment, Date of Original (Month/Year) ================================================================================ 7. Individual or Joint/Group Filing (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) - -------------------------------------------------------------------------------- Common Stock None (2) - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- ================================================================================ Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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: NETREX HOLDINGS, L.L.C., a Delaware limited liability corporation /s/ Peter I. Cavallaro Its: Secretary December 29, 2000 ------------------------------------- ----------------- **Signature of Reporting Person Date (1) The Reporting Person may be deemed to share voting and dispositive power over the shares of Common Stock of the Issuer described in Item 4. The Reporting Person disclaims beneficial ownership of these securities and the filing of this Form 3 shall not be deemed an admission that the Reporting Person is a beneficial owner or has voting or dispositive power over such securities for any purposes under the Act. (2) Does not include 5,258,513 shares owned by United Financial Adjusting Company with regard to which the Reporting Person disclaims any beneficial interest. ** 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-----