5 1 pintoapril2002.htm FORM 5 SEC FORM 5

FORM 5

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

Form 4 Transactions Reported

U.S. 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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940

OMB APPROVAL

OMB Number: 3235-0362

Expires: January 31, 2005

Estimated average burden

hours per response . . . . . . . .1.0

1. Name and Address of Reporting Person

 

Pinto, James J.

2. Issuer Name and Ticker or Trading Symbol

 

Andersen Group, Inc. (ANDR)

6. Relationship of Reporting Person(s) to Issuer

(Check all applicable)





(Last) (First) (Middle)

366 Round Hill Road

3. IRS Identification Number of Reporting Person, if an entity (Voluntary)

4. Statement for

Month/Year

Year Ended

February 28, 2002

X Director 10% Owner

Officer (give Other (specify

title below) below)

________________________________________



(Street)

Greenwich, CT 06830

5. If Amendment, Date of

Original

(Month/Year)

7. Individual or Joint/Group Filling (Check Applicable Line)

X Form filed by One Reporting Person

Form filed by More than One Reporting Person

(City) (State) (Zip)

Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security

(Instr. 3)

2. Trans-

action

Date

(Month/

3. Trans-

action

Code

(Instr. 8)

4. Securities Acquired (A) or

Disposed of (D)

(Instr. 3, 4 and 5)

5. Amount of Securities Bene-ficially Owned

at End of

6. Owner-

ship

Form:

Direct

7. Nature of Indirect Bene-

ficial

 

Day/

Year)

 

 

 

 

Issuer's

Fiscal Year

(D) or

Indirect

Owner-

ship

 

 

 

Amount

(A) or (D)

Price

(Instr. 3 and 4)

(I)

(Instr. 4)

(Instr. 4)

Andersen Group, Inc. Common Stock

 

 

 

 

 

53,515

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

FORM 5 (Continued)

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. Conver-sion or Exercise Price of Deriv-

ative Security

3. Trans-action Date (Month/

Day/

Year)

4. Trans-

action

Code

(Instr. 8)

5. Number of Derivative Securities Ac-quired (A) or Disposed of

(D)

(Instr. 3, 4 and 5)

6. Date Exer-cisable and Expiration

Date

(Month/Day/

Year)

7. Title and Amount of Underlying Securities (Instr. 3 and 4)

8. Price

of Deriv-ative Secu-

rity (Instr. 5)

9. Number of Deriv-ative

Secur-

ities

Bene-ficially Owned

at End

10. Owner-ship Form

of Deri-

vative Secu-rity Direct (D) or In-direct

(I)

(Instr. 4)

11. Na-ture of Indirect Bene-ficial Owner-ship

(Instr. 4)

 

 

 

 

 

(A)

(D)

Date Exer-

Expir-ation

Title

Amount or Number of

 

of Year

(Instr. 4)

 

 

 

 

 

 

 

 

 

cisable

Date

 

Shares

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

10 1/2% Convertible Subordinated Debentures

16.17

10/15/01

H

 

 

1000

 

10/15/01

Common Stock

61

$1,000

247

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Stock Options

 

 

 

 

 

 

 

 

 

 

3.8125

3,000

D

 

Stock Options

 

 

 

 

 

 

 

 

 

 

6.125

3,000

D

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Explanation of Responses:

.

 

 

___________________________________ ________________________

**Intentional misstatements or omissions of facts constitute Federal Criminal Violations. **Signature of Reporting Person Date

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 provided is insufficient, see Instruction 6 for procedure.