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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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(h) of the Investment Company Act of 1940 |
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| Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
| 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 control number. | SEC 1474 (9-02) | ||
| 1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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| Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
| Common Stock Purchase Warrant (Right to Buy) | $ 0.9 | 03/30/2005 | A | 100,000 | 03/30/2005 | 03/29/2012 | Common Stock | 100,000 | $ 0.9 | 100,000 | I | Indirect (1) | |||
| CommonStock Warrant (Right to Buy) | $ 0.9225 | 05/26/2004 | A | 135,502 | 03/15/2006 | 03/15/2009 | Common Stock | 135,502 | $ 0.9225 | 135,502 | I | Indirect (1) | |||
| Common Stock Warrant (Righ to Buy) | $ 0.9348 | 05/26/2004 | A | 176,508 | 12/18/2005 | 12/18/2008 | Common Stock | 176,508 | $ 0.9348 | 176,508 | I | Indirect (1) | |||
| Option to Purchase | $ 0.75 | 12/01/2003 | A | 250,000 | 12/01/2005 | 12/01/2008 | Common Stock | 250,000 | $ 0.75 | 250,000 | I | Indirect (1) | |||
| 2002 Stock Option Plan | $ 0.75 | 12/01/2003 | A | 31,000 | 12/01/2005 | 12/01/2008 | Common Stock | 31,000 | $ 0.75 | 31,000 | I | Indirect (1) | |||
| 2002 A Stock Option Plan | $ 0.75 | 12/01/2003 | A | 47,000 | 12/01/2005 | 12/01/2008 | Common Stock | 47,000 | $ 0.75 | 47,000 | I | Indirect (1) | |||
| 2003 Stock Option Plan | $ 0.75 | 12/01/2003 | A | 47,000 | 12/01/2005 | 12/01/2008 | Common Stock | 47,000 | $ 0.75 | 47,000 | I | Indirect (1) | |||
| 2003 A Stock Option Plan | $ 0.75 | 12/01/2003 | A | 25,000 | 12/01/2005 | 12/01/2008 | Common Stock | 25,000 | $ 0.75 | 25,000 | I | Indirect (1) | |||
| 2003 A Stock Option Plan | $ 1.26 | 07/16/2003 | A | 8,000 | 03/31/2005 | 04/01/2006 | Common Stock | 8,000 | $ 1.26 | 8,000 | I | Indirect (1) | |||
| Series A Convertible Preferred Stock | $ 1.4 | 06/03/2003 | A | 178,570 | 06/30/2003 | 09/25/2008 | Common Stock | 178,570 (5) | $ 1.4 (5) | 178,570 | I | Indirect (1) | |||
| 2003 A Stock Option Plan | $ 1.4 | 03/31/2003 | A | 75,000 | 03/31/2005 | 04/01/2006 | Common Stock | 75,000 | $ 1.4 | 75,000 | I | Indirect (1) | |||
| Common Stock Warrant (Right to Buy) | $ 2.125 | 12/10/2003 | A | 150,000 | 12/10/2005 | 12/10/2008 | Common Stock | 150,000 | $ 2.125 | 150,000 | I | Indirect (1) | |||
| Series A Convertible Preferred Stock | $ 2.14 | 01/02/2003 | A | 23,365 | 01/02/2003 | 09/25/2008 | Common Stock | 233,650 | $ 21.4 (5) | 23,365 | I | Indirect (1) | |||
| 2002 A Stock Option Plan | $ 2 | 12/29/2002 | A | 30,000 | (6) | 09/30/2007 | Common Stock | 30,000 | $ 2 | 30,000 | I | Indirect (1) | |||
| Series A Convertible Preferred Stock | $ 2.14 | 10/04/2002 | A | 934,580 | 10/04/2002 | 09/25/2008 | Common Stock | 934,580 | $ 2.14 | 934,580 | I | Indirect (1) | |||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Levin Michael 257 PARK AVENUE SOUTH 15TH FLOOR NEW YORK, NY 10010 |
X | |||
| /s/Michael Levin | 09/21/2005 | |
| **Signature of Reporting Person | Date |
| * | If the form is filed by more than one reporting person, see Instruction 4(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). |
| (1) | The securities are owned by Metropolitan Venture Partners II, L.P. ("MetVP"). the Reporting Person is a managing director of MetVP. In addition, the Reporting Person is a limited partner in Metropolitan Venture Partners ("Advisors"), L.P. ("MetVP Advisors"), which is the general partner of MetVP and is on the board of directors and is a shareholder of Metropolitan Venture Partners Corp. ("MetVP Corp."), which is the general partner of MetVP Advisors. As a result of the foregoing, the Reporting Person may be deemed to own beneficially and indirectly the securities. The Reporting Person disclaims beneficial ownership of the securities except to the extent of his pecuniary interest therein. |
| (2) | Shares were transferred to Metropolitan Venture Partners II, L.P. ("MetVP") by a managing director of Met V.P. |
| (3) | Reporting Person transferred the shares to MetVP. |
| (4) | Shares were issued pursuant to the 2004 Stock Issuance/Stock Option Plan as payment for services rendered as a board member for the fiscal year to date. |
| (5) | The reported number of shares of Common Stock underlying the Series A Convertible Preferred Stock reflects the initial conversion rate of 1-for-10 pursuant to the terms of Series A Convertible Preferred Stock. |
| (6) | Options vest at the rate of 10,000 options on June 30, 2003, 10,000 options on June 30, 2004 and 10,000 options on June 30, 2005. |
| Remarks: Footnote (7) Reporting Person may be deemed to be a director for purposes of Section 16 of the Securities Exchange Act of 1934, as amended (the "Exchange Act") by reason of its right to nominate one person to serve on the Board of Directors of Direct Insite Corp. (the "Company") in accordance with terms and conditions of a Stock Purchase and Registration Rights Agreement dated as of September 25, 2002 by and between Reporting Person and the Company. | |