-----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, C+fuc6IfN9LY43T/d2aCARLwGD50WBaSVc2Wr89FQenNZxilyvXdcaW8mdflnKAZ d74Br5ssHXK4H/9oLCEElg== 0000918545-02-000003.txt : 20020413 0000918545-02-000003.hdr.sgml : 20020413 ACCESSION NUMBER: 0000918545-02-000003 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20011231 FILED AS OF DATE: 20020110 COMPANY DATA: COMPANY CONFORMED NAME: GREGORY PAUL R CENTRAL INDEX KEY: 0001045430 STANDARD INDUSTRIAL CLASSIFICATION: ARRANGEMENT OF TRANSPORTATION OF FREIGHT & CARGO [4731] DIRECTOR STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: 5122 HUISACHE CITY: HOUSTON STATE: TX ZIP: 77401 BUSINESS PHONE: 7137433828 MAIL ADDRESS: STREET 1: 5122 HUISACHE CITY: HOUSTON STATE: TX ZIP: 77401 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: BALTIC INTERNATIONAL USA INC CENTRAL INDEX KEY: 0000918545 STANDARD INDUSTRIAL CLASSIFICATION: ARRANGEMENT OF TRANSPORTATION OF FREIGHT & CARGO [4731] IRS NUMBER: 760336843 STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-26558 FILM NUMBER: 2505909 BUSINESS ADDRESS: STREET 1: 5151 SAN FELIPE STREET 2: SUITE 1661 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: 7139619299 MAIL ADDRESS: STREET 1: 5151 SAN FELIPE STREET 2: SUITE 1661 CITY: HOUSTON STATE: TX ZIP: 77056 4 1 r4-prg1201.txt UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP ( ) Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instructions 1(b). 1. Name and Address of Reporting Person PAUL R. GREGORY 5122 HUISACHE BELLAIRE, TX 77401 2. Issuer Name and Ticker or Trading Symbol BALTIC INTERNATIONAL USA, INC. BISA 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Statement for Month/Year December 2001 5. If Amendment, Date of Original (Month/Year) 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) 7. 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 |2. |3. |4.Securities Acquired (A) |5.Amount of |6.Dir |7.Nature of Indirect | | Transaction | or Disposed of (D) | Securities |ect | Beneficial Ownership | | | | | Beneficially |(D)or | | | | | | | A/| | Owned at |Indir | | | Date |Code|V| Amount | D | Price | End of Month |ect(I)| | ___________________________________________________________________________________________________________________________________| | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________| ___________________________________________________________________________________________________________________________________ Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned | ___________________________________________________________________________________________________________________________________| 1.Title of |2.Con- |3. |4. |5.Number of |6.Date Exer |7.Title and Amount |8.Price|9.Number of |10.|11.Nature of| Derivative |version |Transaction | Derivative |cisable and | of Underlying |of Deri| Derivative |Dir| Indirect | Security |or | | | Securities |Expiration | Securities |vative | Securities |ect| Beneficial | |Exercise| | | Acquired(A) or|Date(Month/ | |Secu | Benefi |(D)| Ownership | |Price of| | | Disposed of(D)|Day/Year) | |rity | ficially |or | | |Deriva- | | | |Date |Expir | | | Owned at |Ind| | |tive | | | | A/|Exer- |ation | Title and Number | | End of |ire| | |Secu- | | | | | D |cisable |Date | of Shares | | Month |ct | | |rity | Date |Code|V| Amount | | | | | | |(I)| | ___________________________________________________________________________________________________________________________________| Options |$0.8125 |12/19/01| H | | 5000 | D | |12/19/01|Common stock|5000 | | 25000 | D | | - -----------------------------------------------------------------------------------------------------------------------------------| Options |$0.12 |12/19/01| T | | 5000 | A |12/19/01|12/19/06|Common stock|5000 | (1) | 25000 | D | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) These options were granted pursuant to the Issuer's 1992 Equity Incentive Plan; therefore, no consideration was paid. /s/David A. Grossman, Attorney-in-Fact January 10, 2002 - ----------------------------------------- ----------------------- SIGNATURE OF REPORTING PERSON DATE -----END PRIVACY-ENHANCED MESSAGE-----