-----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, KS3lcOCCQr+wxiAdLS4dQlmnwPEzs+cUK5uEUNrQNHtrng421UILzXD8nODZg2DZ 3hNViYPBUSPCvMdSi3qzIg== 0000918545-03-000001.txt : 20030102 0000918545-03-000001.hdr.sgml : 20030101 20030102161712 ACCESSION NUMBER: 0000918545-03-000001 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20021230 FILED AS OF DATE: 20030102 REPORTING-OWNER: COMPANY DATA: COMPANY CONFORMED NAME: GREGORY PAUL R CENTRAL INDEX KEY: 0001045430 STANDARD INDUSTRIAL CLASSIFICATION: ARRANGEMENT OF TRANSPORTATION OF FREIGHT & CARGO [4731] RELATIONSHIP: 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: 03501079 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-prg123002.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 5151 SAN FELIPE, SUITE 1661 HOUSTON, TX 77056 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/Day/Year December 30, 2002 5. If Amendment, Date of Original (Month/Day/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 Following |Indir | | | Date |Code|V| Amount | D | Price | Reported Transac.|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 |Ind| | |tive | | | | A/|Exer- |ation | Title and Number | | Following |ire| | |Secu- | | | | | D |cisable |Date | of Shares | | Reported |ct | | |rity | Date |Code|V| Amount | | | | | | Transaction|(I)| | ___________________________________________________________________________________________________________________________________| Series A | (1) |12/30/02| S | | 22750 | D |06/30/95| N/A |Common Stock|250000|$0.0001| 0 | I | (2) | Preferred | | | | | | | | | | | | | | | Stock | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| | | | | | | | | | | | | | | | - -----------------------------------------------------------------------------------------------------------------------------------| ___________________________________________________________________________________________________________________________________|
Explanation of Responses: (1) The Issuer's Convertible Redeemable Series A Preferred Stock has a par value of $10.00 per share and are currently convertible into the Issuer's common shares at a conversion price of $0.91 per share. (2) These securities were owned by a limited partnership in which Mr. Gregory is the general partner. /s/David A. Grossman, Attorney-in-Fact December 31, 2002 - ----------------------------------------- ----------------------- SIGNATURE OF REPORTING PERSON DATE -----END PRIVACY-ENHANCED MESSAGE-----