| FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 05/03/2018 | 3. Issuer Name and Ticker or Trading Symbol VOLT INFORMATION SCIENCES, INC. [ VISI ] | |||||||||||||
| 4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. If Amendment, Date of Original Filed (Month/Day/Year) | ||||||||||||||
6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
|---|---|---|---|
| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
| Common Stock, $0.01 par value | 119,852(1) | D | |
| Common Stock, $0.01 par value | 750,872 | I | Co-trustee(1)(4) |
| Common Stock, $0.01 par value | 1,052,583 | I | Co-trustee(2)(3) |
| Common Stock, $0.01 par value | 1,401,547 | I | Co-trustee(4) |
| Common Stock, $0.01 par value | 12,750 | I | Officer and director of corporate owner(3) |
| Common Stock, $0.01 par value | 7,650 | I | Beneficiary of 401K of another(5) |
| Common Stock, $0.01 par value | 798 | I | Beneficiary of ESOP plan of another(6) |
| Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Emplpoyee Stock Option (Right to Buy) | (7) | 04/06/2019 | Common Stock, $0.01 par value | 8,000 | 6.39 | I | Co-trustee(4) |
| Explanation of Responses: |
| 1. Jointly owned with Reporting Person's spouse. |
| 2. Reporting Person is a co-trustee of a trust for the benefit of another. |
| 3. Reporting Person disclaims any beneficial ownership of these shares. Reporting Person has no current pecuniary interest in these shares except as a co-trustee or officer or director. |
| 4. Reporting Person is a co-trustee and beneficiary of this trust. |
| 5. Reporting Person is the beneficiary of on-third of the holdings of a 401K of another. Upon the death of the Reporting Person's father on May 3, 2018, Reporting Person has the right to acquire these shares within 60 days. |
| 6. Reporting Person is the beneficiary of one-third of the holdings of an ESOP of another. Upon the death of Reporting Person's father on May 3, 2018, Reporting Person has the right to acquire these shares within 60 days. |
| 7. Option vests in 20% annual installments, on a cumulative basis, commencing 4/7/2010, one year after the date of the original grant of the option. |
| Michael Shaw | 06/05/2018 | |
| ** 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 5 (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. | ||
