FORM 4
Check this box if no longer subject to Section 16. Form 4 (Print or Type Responses) |
UNITED STATES SECURITIES AND EXCHANGE
COMMISSION STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the PublicUtility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person* |
2. Issuer Name and Ticker or Trading
Symbol |
6. Relationship of Reporting Person(s) to Issuer (Check all applicable) X Director 10% Owner Officer (give title below) Other (specify below) ___________________________________ |
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Galloway, Bruce |
3. I.R.S. Identification Number of Reporting Person, if an entity (voluntary) |
4. Statement for Month/Day/Year |
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(Last) (First)
(Middle) |
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1801 Green Road Suite E. |
5. If Amendment, Date of Original (Month/Day/Year) |
7. Individual or Joint/Group Filing (Check Applicable Line) X Form filed by One Reporting
Person |
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(Street) Pompano Beach, Fl 33064 |
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(City) (State) (Zip) |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1. Title of
Security |
2. Transaction Date
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2A. Deemed
Execution Date, if any |
3. Transaction Code |
4. Securities Acquired (A) |
5. Amount of Securities Beneficially Owned
Following Reported Transactions(s) |
6. Ownership Form:
Direct (D) or Indirect (I) |
7. Nature of
Indirect Beneficial Ownership |
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Code |
V |
Amount |
(A) or (D) |
Price |
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179,020 |
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Table II - Derivative Securities
Acquired, Disposed of, or Beneficially Owned |
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1. Title of
Derivative Security |
2. Conversion or Exercise Price of Derivative Security |
3. Transaction Date
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3A. Deemed
Execution Date, if any |
4. Transaction Code |
5. Number of
Derivative Securities Acquired (A) or Disposed of (D) |
6. Date |
7. Title and Amount
of Underlying Securities |
8. Price of
Derivative Security |
9. Number of
Derivative Securities Beneficially Owned Following Reported Transaction(s) |
10. Ownership Form
of Derivative Securities Beneficially Owned at End of Month |
11. Nature of
Indirect Beneficial Ownership |
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Code |
V |
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
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Common Stock Options |
$2.05 |
04/25/03 |
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A |
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04/25/03 |
04/24/13** |
Forward Industries Common Stock |
10,000 |
$2.05 |
10.000 |
D |
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Explanation of Responses: |
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//s//Bruce Galloway |
April 25, 2003
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Reminder: |
Report on a separate line for each class of securities beneficially owned directly or indirectly. |
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* |
If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
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** |
Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
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Note: |
File three copies of this Form, on of which must be manually signed. If space is insufficient, see Instruction 6 for procedure |