SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
X
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
LAZAREWICZ GARRY L

(Last) (First) (Middle)
2 CHRISTIE HEIGHTS STREET

(Street)
LEONIA NJ 07605

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
INFOCROSSING INC [ IFOX ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
SVP
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2003
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
Common stock 02/07/2000 X4 3,000 A $4 0 D
Common stock 02/07/2000 X4 3,000 A $3.625 0 D
Common stock 02/07/2000 X4 1,500 A $4.4375 0 D
Common stock 12/29/2000 S4 7,500 D $5.7 0 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Option to purchase common stock $9.2188 08/15/1999 4A 10,000 08/15/2004(1) 08/14/2009 Infocrossing common stock 10,000 $0 19,700 D
Option to purchase common stock $27.25 12/16/1999 4A 200 12/16/1999 12/15/2009 Infocrossing common stock 200 $0 19,700 D
Option to purchase common stock $4 02/07/2000 4X 3,000 10/16/1999 10/16/2005 Infocrossing common stock 3,000 $0 12,200 D
Option to purchase common stock $3.625 02/07/2000 4X 3,000 07/26/1999 07/25/2006 Infocrossing common stock 3,000 $0 12,200 D
Option to purchase common stock $4.4375 02/07/2000 4X 1,500 05/05/1999 05/05/2007 Infocrossing common stock 1,500 $0 12,200 D
Option to purchase common stock $6.2685 02/04/2002 4A 1,000 02/04/2005(2) 02/03/2012 Infocrossing common stock 1,000 $0 13,200 D
Option to purchase common stock $6.9755 01/30/2003 4A 1,000 01/30/2006(2) 01/29/2013 Infocrossing common stock 1,000 $0 16,200 D
Option to purchase common stock $9.91 12/15/2003 4A 2,000 12/15/2006(2) 12/14/2013 Infocrossing common stock 2,000 $0 16,200 D
Explanation of Responses:
1. Vests 1/5 per year through the full vesting date
2. Vests as to one third on the first anniversary of the grant, then vests as to 1/36 each month for 24 months
GARRY LAZAREWICZ 05/13/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** 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 is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.