-----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, R5+sr/NqAaUkaOBb8VPo556i2LIgJedtW3PhT9wBWI8R6xvE1n6MbTNtRpOzQddx OevcFz4VMRqyG99Urw55tg== 0000950134-04-009705.txt : 20040707 0000950134-04-009705.hdr.sgml : 20040707 20040706173712 ACCESSION NUMBER: 0000950134-04-009705 CONFORMED SUBMISSION TYPE: SC 13D/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040707 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: COLLEGIATE PACIFIC INC CENTRAL INDEX KEY: 0000828747 STANDARD INDUSTRIAL CLASSIFICATION: RETAIL-CATALOG & MAIL-ORDER HOUSES [5961] IRS NUMBER: 222795073 STATE OF INCORPORATION: DE FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: SC 13D/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-40925 FILM NUMBER: 04903104 BUSINESS ADDRESS: STREET 1: 13950 SEMLAC STREET 2: SUITE 200 CITY: DALLAS STATE: TX ZIP: 75234 BUSINESS PHONE: 9722438100 MAIL ADDRESS: STREET 1: 13950 SEMLAC STREET 2: SUITE 200 CITY: DALLAS STATE: TX ZIP: 75234 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/A 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/A 1 d16604a5sc13dza.htm AMENDMENT TO SCHEDULE 13D sc13dza
 

SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549


SCHEDULE 13D

(Rule 13d-101)

Information To be Included In Statements filed Pursuant to Rule
13d-1(a) and Amendments Thereto Filed Pursuant to Rule 13d-2(a)
(Amendment No. 5)1

COLLEGIATE PACIFIC INC.


(Name of Issuer)

Common Stock, par value $0.01 per share


(Title of Class of Securities)

194589-10-7


(Cusip Number)

Michael J. Blumenfeld
13950 Senlac Drive, Suite 100
Dallas, Texas 75235
(972) 243-8100


(Name, Address and Telephone Number of Person
Authorized to Receive Notices and Communications)

February 19, 2004


(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(e), 13d-1(f) or 13(d)-1(g), check the following box. o


     1The 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 purpose of Section 18 of the Securities Exchange Act of 1934 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).

 


 

             
CUSIP No. 195489-10-7 Page 2 of 5 Pages

  1. Name of Reporting Person:
Michael J. Blumenfeld
I.R.S. Identification Nos. of above persons (entities only):

  2. Check the Appropriate Box if a Member of a Group (See Instructions):
    (a) o  
    (b) o  

  3. SEC Use Only:

  4. Source of Funds (See Instructions):
PF;SC

  5. Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e): o

  6. Citizenship or Place of Organization:
United States

Number of
Shares
Beneficially
Owned by
Each Reporting
Person With
7. Sole Voting Power:
2,197,276

8. Shared Voting Power:
0

9. Sole Dispositive Power:
2,197,276

10.Shared Dispositive Power:
0

  11.Aggregate Amount Beneficially Owned by Each Reporting Person:
2,197,276

  12.Check if the Aggregate Amount in Row (11) Excludes Certain Shares (See Instructions):
o

  13.Percent of Class Represented by Amount in Row (11):
22.2%

  14.Type of Reporting Person (See Instructions):
IN


 

Cusip No. 194589-10-7   Page 3 of 5 Pages

SCHEDULE 13D

Item 1. Security and Issuer.

     This Amendment No. 5 (the “Fifth Amendment”) to the Statement on Schedule 13D (the “Schedule 13D”) originally filed on February 18, 1998, and amended on January 30, 2001, June 13, 2002, October 7, 2003, and February 16, 2004 (collectively, the “Amendments”) by Michael J. Blumenfeld (the “Reporting Person”), relates to shares of the common stock of Collegiate Pacific Inc., a Delaware corporation (“Collegiate Pacific”), $0.01 par value (the “Common Stock”). All capitalized terms used and not otherwise defined herein shall have the meanings assigned to those terms in the Schedule 13D and the Amendments. The principal executive offices of Collegiate Pacific are located at 13950 Senlac Drive, Suite 100, Dallas, Texas 75234.

Item 5. Interest in Securities of the Issuer.

     The information contained in Item 5 of the Schedule 13D is hereby amended and supplemented by adding the following information:

     (a) As of July 6, 2004, Mr. Blumenfeld may be deemed to beneficially own an aggregate of 2,197,276 shares of Common Stock, or approximately 22.2% of the outstanding shares of Common Stock (based upon Collegiate Pacific’s Registration Statement on Form S-3 filed on June 8, 2004), and has sole voting and dispositive power with respect to all those shares. Of the shares beneficially owned by Mr. Blumenfeld, 130,000 of such shares represent options to acquire shares of Common Stock, none of which have been exercised by Mr. Blumenfeld as of the date of this report.

     (b) Items 7-11 and 13 of the cover page of this Fifth Amendment, which relate to the beneficial ownership of shares of Common Stock by the Reporting Person, are incorporated by reference in response to this item.

     (c) No transactions involving the Common Stock were effected by Mr. Blumenfeld since Amendment No. 4 to this Schedule 13D was filed on February 16, 2004 except for the gifts described below:

                         
Date of   Number of Shares of        
Transaction
  Common Stock
  Transaction
  Price
04/19/04
  500   Gift      
03/15/04
  500   Gift      
02/19/04
  80,000   Gift      

     The following transactions involving the common stock purchase warrants of Collegiate Pacific were effected by Mr. Blumenfeld since Amendment No. 4 to this Schedule 13D was filed on February 16, 2004. All of the outstanding common stock purchase warrants were canceled on May 20, 2004:

                         
Date of   Number of        
Transaction
  Warrants
  Transaction
  Price
04/14/04
  5,200   Sale   $ 4.97  
04/14/04
  5,000   Sale   $ 5.02  
04/05/04
  4,600   Sale   $ 4.88  
04/05/04
  2,200   Sale   $ 4.95  
04/02/04
  3,000   Sale   $ 4.85  
04/02/04
  3,000   Sale   $ 4.79  
04/01/04
  4,000   Sale   $ 4.33  
03/31/04
  1,500   Sale   $ 4.39  
03/31/04
  2,000   Sale   $ 4.33  
03/30/04
  3,000   Sale   $ 4.20  
03/30/04
  1,000   Sale   $ 4.21  
03/29/04
  2,000   Sale   $ 4.08  
03/29/04
  3,000   Sale   $ 4.10  
03/29/04
  3,000   Sale   $ 4.16  
03/29/04
  3,000   Sale   $ 4.18  
03/05/04
  3,000   Sale   $ 4.84  
03/05/04
  3,000   Sale   $ 4.89  
03/04/04
  7,000   Sale   $ 4.92  
03/03/04
  3,000   Sale   $ 5.04  
03/03/04
  3,000   Sale   $ 4.98  
03/03/04
  3,000   Sale   $ 4.96  
03/03/04
  5,000   Sale   $ 4.94  
02/25/04
  500   Sale   $ 4.70  
02/25/04
  74,500   Sale   $ 4.65  
02/20/04
  40,000   Sale   $ 5.10  
02/19/04
  163,000   Sale   $ 5.15  
02/19/04
  6,000   Sale   $ 5.19  
02/18/04
  65,000   Sale   $ 5.05  

 


 

Cusip No. 194589-10-7   Page 4 of 5 Pages

SIGNATURES

     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: July 6, 2004
         
     
  /s/ Michael J. Blumenfeld    
  Michael J. Blumenfeld   
     
 

 

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