-----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, I99eDI+i5LgnxggWRp9oF7tI5YzKXM2HBD56RuosLJ0jEb3AhBUgMG2KmJgHy+Qx 5fuOZfCHXx4ngY+KtsUaCA== 0000950134-98-001681.txt : 19980304 0000950134-98-001681.hdr.sgml : 19980304 ACCESSION NUMBER: 0000950134-98-001681 CONFORMED SUBMISSION TYPE: SC 13D PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19980303 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COLLEGIATE PACIFIC INC CENTRAL INDEX KEY: 0000828747 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 752701168 STATE OF INCORPORATION: PA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D SEC ACT: SEC FILE NUMBER: 005-40925 FILM NUMBER: 98556644 BUSINESS ADDRESS: STREET 1: 13950 SEMLAC STREET 2: SUITE 200 CITY: FARMERS BRANCH STATE: TX ZIP: 75235 BUSINESS PHONE: 9722438100 MAIL ADDRESS: STREET 1: 13950 SEMLAC STREET 2: SUITE 200 CITY: FARMERS BRANCH STATE: TX ZIP: 75235 FORMER COMPANY: FORMER CONFORMED NAME: DSSI CORP DATE OF NAME CHANGE: 19971031 FORMER COMPANY: FORMER CONFORMED NAME: DRUG SCREENING SYSTEMS INC DATE OF NAME CHANGE: 19920703 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: BLUMENFELD MICHAEL J CENTRAL INDEX KEY: 0000904289 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13D BUSINESS ADDRESS: STREET 1: 13950 SEMLAC STE 200 CITY: DALLAS STATE: TX ZIP: 75235 BUSINESS PHONE: 2144849484 MAIL ADDRESS: STREET 1: 1717 MAIN STREET STREET 2: SUITE 2800 CITY: DALLAS STATE: TX ZIP: 75201 SC 13D 1 SCHEDULE 13D 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13D UNDER THE SECURITIES EXCHANGE ACT OF 1934 Collegiate Pacific Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock, Par Value $.01 - -------------------------------------------------------------------------------- (Title of Class of Securities) 194589 10 7 ---------------------------------------- (CUSIP Number) Michael J. Blumenfeld 13950 Semlac; Suite 200 Farmers Branch, Texas 75235 (972) 243-8100 - -------------------------------------------------------------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) February 18, 1998 ------------------------------------------------------------------- (Date of Event which Requires Filing of this Statement) If the filing person has previously filed a statement on Schedule 13G to report the acquisition which is the subject of this Schedule 13D, and is filing this schedule because of Rule 13d-1(b)(3) or (4), check the following box . NOTE: Six copies of this statement, including all exhibits, should be filed with the Commission. See Rule 13d-1(a) for other parties to whom copies are to be sent. - --------------- The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. The information required on the remainder of this cover page shall not be deemed to be "filed" for the purposes of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). 2 SCHEDULE 13D CUSIP NO. 194589 10 7 PAGE 2 OF 4 PAGES - -------------------------------------------------------------------------------- 1 NAME OF REPORTING PERSON S.S. OR I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Michael J. Blumenfeld - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) / / (b) / / - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 SOURCE OF FUNDS PF - -------------------------------------------------------------------------------- 5 CHECK BOX IF DISCLOSURE OF LEGAL PROCEEDINGS IS REQUIRED PURSUANT TO ITEMS 2(D) OR 2(E) / / Not Applicable. - -------------------------------------------------------------------------------- 6 CITIZENSHIP OR PLACE OF ORGANIZATION Texas - -------------------------------------------------------------------------------- 7 SOLE VOTING POWER NUMBER OF SHARES 9,755,600 BENEFICIALLY ----------------------------------------------------------------- OWNED BY 8 SHARED VOTING POWER EACH REPORTING PERSON ----------------------------------------------------------------- WITH 9 SOLE DISPOSITIVE POWER 9,755,600 ----------------------------------------------------------------- 10 SHARED DISPOSITIVE POWER - -------------------------------------------------------------------------------- 11 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9,755,600 - -------------------------------------------------------------------------------- 12 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (11) EXCLUDES CERTAIN SHARES / / - -------------------------------------------------------------------------------- 13 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (11) 59.7% - -------------------------------------------------------------------------------- 14 TYPE OF REPORTING PERSON IN - -------------------------------------------------------------------------------- 3 ITEM 1. SECURITY AND ISSUER The class of securities to which this statement relates is the common stock, $01. par value ("Issuer Common Stock"), of Collegiate Pacific, Inc., a Pennsylvania corporation (the "Issuer"), the principal executive offices of which are located at 13950 Semlac, Suite 200, Farmers Branch, Texas 75235. ITEM 2. IDENTITY AND BACKGROUND (a)-(c), (f) Michael J. Blumenfeld, a citizen of the United States of America, is President of Collegiate Pacific Inc. Mr. Blumenfeld's business address is 13950 Semlac, Suite 200, Farmers Branch, Texas 75235. (d)-(e) Mr. Blumenfeld has not, during the last five years, been (i) convicted in a criminal proceeding or (ii) a party to a civil proceeding of a judicial or administrative body of competent jurisdiction as a result of which such person was subject to a judgment, decree or final order enjoining future violations of, or prohibiting or mandating activities subject to, federal or state securities law or finding any violation with respect to such laws. ITEM 3. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION Personal funds of Mr. Blumenfeld. ITEM 4. PURPOSE OF TRANSACTION 4(f) Mr. Blumenfeld purchased 9,700,000 shares of Issuer Common Stock from the Issuer on February 18, 1998 pursuant to a Stock Purchase Agreement dated August 18, 1997. As a result of this transaction, the business of the Issuer has changed from drug testing to the manufacture and distribution of sports equipment. Mr. Blumenfeld has no present plans or proposals which relate to or would result in the occurrence of the events described in Items 4(a) - 4(e) or Items 4(g)-4(j). ITEM 5. INTEREST IN SECURITIES OF THE ISSUER (a) Mr. Blumenfeld beneficially owns 9,755,600 shares of the Common Stock, which represents approximately 59.7% of the outstanding Issuer Common Stock. (b) Mr. Blumenfeld exercises the sole voting and dispositive power with respect to the trust shares of the Issuer Common Stock set forth in Item 5(a). (c) On February 18, 1998, Mr. Blumenfeld purchased 9,700,000 shares of Issuer Common Stock for $.20 per share. 4 (d) None. (e) Not Applicable. ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT TO SECURITIES OF THE ISSUER. Mr. Blumenfeld serves as President of Issuer. To the best knowledge of the undersigned, there are no other contracts, arrangements, understandings or relationships (legal or otherwise) among the persons named in Item 2 and between such persons and any person with respect to any securities of the Issuer, including, but not limited to, transfer or voting of any of the securities, finder's fees, joint ventures, loan or option agreement, puts or calls, guarantees of profits, division of profits or loss, or the giving or withholding of proxies. ITEM 7. MATERIAL TO BE FILED AS EXHIBITS The Stock Purchase Agreement between Mr. Blumenfeld and Issuer was filed with the Securities and Exchange Commission on January 30, 1998 as an exhibit to the Issuer's Proxy Statement for Special Meeting of Stockholders. After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated as of February 27, 1998 By: /s/ Michael J. Blumenfeld --------------------------------- Michael J. Blumenfeld -----END PRIVACY-ENHANCED MESSAGE-----