-----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, GcRmhYIRkUChsc3KS3j0lQXDicV2ilLQfYryYim4x5ONpPcbd+enp7l/ezEzUDW7 uFu+9VHaBuXu2YowIled8Q== 0000918545-98-000001.txt : 19980112 0000918545-98-000001.hdr.sgml : 19980112 ACCESSION NUMBER: 0000918545-98-000001 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971231 FILED AS OF DATE: 19980109 SROS: NASD 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: 3 SEC ACT: SEC FILE NUMBER: 000-26558 FILM NUMBER: 98503475 BUSINESS ADDRESS: STREET 1: 1990 POST OAK BLVD STREET 2: SUITE 1630 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: 7139619299 MAIL ADDRESS: STREET 1: 1990 POST OAK BLVD STREET 2: SUITE 1630 CITY: HOUSTON STATE: TX ZIP: 77056 COMPANY DATA: COMPANY CONFORMED NAME: JOCHNICK ADOLF AF CENTRAL INDEX KEY: 0001045427 STANDARD INDUSTRIAL CLASSIFICATION: ARRANGEMENT OF TRANSPORTATION OF FREIGHT & CARGO [4731] DIRECTOR STATE OF INCORPORATION: TX FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 1990 POST OAK BLVD STREET 2: SUITE 1630 CITY: HOUSTON STATE: TX ZIP: 77056 BUSINESS PHONE: 7139619299 MAIL ADDRESS: STREET 1: 1990 POST OAK BLVD STREET 2: SUITE 1630 CITY: HOUSTON STATE: TX ZIP: 77056 3 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 1. Name and Address of Reporting Person ADOLF AF JOCHNICK PO BOX 71859 W. HARTFORD, CT 06127 2. Date of Event Requiring Statement (Month/Day/Year) DECEMBER 31, 1997 3. IRS or Social Security Number of Reporting Person (Voluntary) 4. Issuer Name and Ticker or Trading Symbol BALTIC INTERNATIONAL USA, INC. BISA 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner ( ) Officer (give title below) ( ) Other (specify below) 6. If Amendment, Date of Original (Month/Year) 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 |$0.40625|12/31/97| T | | 10000 | A |12/11/97|12/11/02|Common stock|10000 |(1) | 10000 |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 9, 1998 - ----------------------------------------- ----------------------- SIGNATURE OF REPORTING PERSON DATE -----END PRIVACY-ENHANCED MESSAGE-----