FORM 3
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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
1. Name and Address of Reporting Person* |
2. Date of Event Requiring Statement for (Month/Day/Year) |
4. Issuer Name and Ticker or Trading Symbol |
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WALES |
KEITH |
RODERICK |
PIVOTAL CORPORATION - PVTL |
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(Last) |
(First) |
(Middle) |
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5690 Raven Place |
3. IRS or Social Security Number of Reporting Person (Voluntary) - |
5. Relationship of Reporting Persons to Issuer (Check all applicable) [X]Director [ ] Other (specify below) |
6. If Amendment, Date of Original (Month/Day/Year) |
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(Street) |
7. Individual or Joint/Group Filing [X]Form filed by One Reporting Person [ ]Form filed by More than One |
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West Vancouver, B.C. V7W 1X2 |
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(City ,State, Zip) * If the Form is filed by more than one Reporting Person, see Instructions 5(b)(v). |
Table I - Non-Derivative Services Beneficially Owned |
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1. Title of Security |
2 Amount of Securities |
3. Ownership Form: |
4. Nature of Indirect Beneficial Ownership |
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common shares |
378,572 |
D |
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common shares |
547,228 |
D |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
(Print or Type Response)
FORM 3 (continued) Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security |
2. Date Exercisable and Expiration Date (Month Day Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion |
5. Ownership Form of Derivative Security: Direct (D) or Indirect (1) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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stock options |
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65,000 |
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D |
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Explanation of Responses: |
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** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. |
/s/ Keith Wales |
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December 9, 2002 |
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See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
**Signature of Reporting Person |
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Date |
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Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, |