U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
FORM 4
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
[_] Check box if no longer subject to Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Gershon Scott
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(Last) (First) (Middle)
6340 NW 5th Way
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(Street)
Fort Lauderdale FL 33309
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Intercallnet, Inc. (ICLN)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
2/02
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person to Issuer
(Check all applicable)
[_] Director [X] 10% Owner
[X] Officer (give title below) [_] Other (specify below)
CEO, Secretary
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7. Individual or Joint/Group Filing (Check applicable line)
[X] Form filed by one Reporting Person
[_] Form filed by more than one Reporting Person
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Table I -- Non-Derivative Securities Acquired, Disposed of,
or Beneficially Owned
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6.
4. 5. Owner-
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code ------------------------------- Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Stock, $.0001 par value 3,062,500 D
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* If the Form is filed by more than one Reporting Person, see Instruction
4(b)(v).
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
(Print or Type Response) (Over)
FORM 4 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner-
Number ship
of Form
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or Derivative 6. of Underlying 8. ities Secur- of
Exer- 4. Securities Date Securities Price Bene- ity: In-
cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship
Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Common Stock
$.0001 par
Stock Option $ .50 2/28/02 A V 100,000 2/28/03 2/28/12 value 100,000 * 100,000 D
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Common Stock
$.0001 par
Stock Option $ .75 2/28/02 A V 100,000 2/28/04 2/28/12 value 100,000 * 100,000 D
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Common Stock
$.0001 par
Stock Option $1.00 2/28/02 A V 50,000 2/28/05 2/28/12 value 50,000 * 50,000 D
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Common Stock
$.0001 par **
Warrant $ .50 11/29/01 A V 25,000 Immed. 11/28/03 value 25,000 12,500 25,000 D
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Common Stock
$.0001 par ***
Warrant $ .50 1/04/02 A V 50,000 Immed. 1/03/04 value 50,000 25,000 50,000 D
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Explanation of Responses:
* Issued in connection with Reporting Person's employment with Issuer.
** Purchase price for purchase of unit consisting of Promissory Note in
the amount of $12,500 and Warrant to purchase 25,000 shares of Issuer's
common stock.
*** Purchase price for purchase of unit consisting of Promissory Note in
the amount of $25,000 and Warrant to purchase 50,000 shares of Issuer's
common stock.
/s/ Scott Gershon March 19, 2002
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**Signature of Reporting Person Date
** 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 provided is insufficient, see Instruction 6 for procedure.
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