FORM 4
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[_] Check this box if no longer subject _________________________________
to Section 16. Form 4 or Form 5 | OMB Number: 3235-0287 |
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Instruction 1(b). | Estimated average burden |
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
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
(Print or Type Responses)
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1. Name and Address of Reporting Person*
Cajolais Jean-Paul
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(Last) (First) (Middle)
5249 Wellington Park Cresent Box E-15
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(Street)
Orlando FL 32839
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
GSI Technologies USA Inc. (GSITB)
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3. IRS or Social Security Number of Reporting Person (Voluntary)
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4. Statement for Month/Year
March, 2001
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5. If Amendment, Date of Original (Month/Year)
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6. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
[X] Director [X] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
Vice president marketing & director of operations USA
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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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5. Amount of 6.Owner-
Securities ship
2. Trans- 3. Trans- 4. Securities Acquired (A) Beneficially Form:
action action or Disposed of (D) Owned at Direct 7.Nature of
Date Code (Instr. 3, 4 and 5) End of (D) or Indirect
1. Title of Security (Month/ (Instr. 8) -------------------------- Month Indirect Beneficial
(Instr. 3) Day/ ---------- Amount (A) or Price (Instr. (I) Ownership
Year) Code V (D) 3 and 4) (Instr. 4) (Instr. 4)
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Common Class B 3/21/01 P 3,500 D $.33 8,000 D
Par value $.001
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Common Class B 3/26/01 P 1,500 D $.39 8,000 D
Par value $.001
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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
4(b)(v).
POTENTIAL PERSONS WHO ARE TO 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. 1473 (3/99)
TABLE II - DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
(E.G. PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES)
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1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11.
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Title and Ownership
Number of Date Exer- Amount of Form of
Derivative cisable and Underlying Number of Deriv-
Securities Expiration Securities Price Derivative ative
Conver- Trans- Acquired (A) Date (Month/ (Instr. 3 of Securities Security:
sion or Trans- action or Disposed Day/Year) and 4) Deriv- Benefi- Direct
Exercise action Code of (D) -------------- -------------- ative cially (D) or Nature of
Title of Price of Date (Instr. (Instr. 3, Date Amount Secur- Owned at Indirect Indirect
Derivative Deriv- (Month/ 8) 4 and 5) Exer- Expir- or Num- ity End of (I) Beneficial
Security ative Day/ -------- ---------- cis- ation ber of (Instr. Month (Instr. Ownership
(Instr. 3) Security Year) Code V (A) (D) able Date Title Shares 5) (Instr. 4) 4) (Instr. 4)
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Explanation of Responses:
* Entity is 100% owned by reporting person.
/s/Jean-Paul Cajolais April 2, 2001
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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.
Potential persons who are to 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.