FORM 5 Check box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). Form 3 Holdings Reported Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 ANNUAL STATEMENT OF CHANGES 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(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
SAFE ID CORPORATION (MYID) |
6. Relationship of Reporting Person(s) to Issuer
(Check all applicable) __X Director _X 10% Owner _X_ Officer (give title ___ Other (specify below) below) President | ||||||
(Last)(First)(Middle)
Forigo, Maurizio |
3. I.R.S. Identification Number of Reporting Person, if an entity (Voluntary) | 4. Statement for
Month/Year
12/2002 |
7. Individual or Joint/Group Reporting
(check applicable line)
__ Form Filed by One Reporting Person __ Form Filed by More than One Reporting Person | |||||
(Street)
1700 Varsity Estate Dr NW, Unit B3 Calgary, Alberta (City)(State)(Zip) |
5. If Amendment,
Date of Original
(Month/Year)
|
|||||||
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||
1. Title of Security
(Inst. 3) |
2. Transaction
Date
(Month/Day/ Year) |
3. Transaction
Code (Inst. 8) |
4. Securities Acquired (A) or Disposed of (D) (Inst. 3, 4, and 5) | 5. Amount of Securities Beneficially Owned at the end of Issuer's Fiscal Year (Inst. 3 and 4) | 6. Ownership
Form: Direct (D) or Indirect (I) (Inst. 4) |
7. Nature of
Indirect Beneficial Ownership (Instr. 4) | ||
Amount |
(A) or (D) | Price | ||||||
COMMON STOCK | 1999 | A | 6,000,000 | A | * | 6,000,000 | D | |
*If the form is filed by more than one reporting person, see instruction 4(b)(v).
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts calls warrants options, convertible securities) | |||||||||||||
1. Title of
Derivative Security (Inst. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans-
action Date (Month/ Day/ Year) |
4. Trans-
action Code (Instr. 8) |
5. Number of
Derivative Securities Acquired (A) or Disposed of (D) (Inst. 3, 4 and 5) |
6. Date Exercisable and
Expiration Date (Month/Day/Year) |
7. Title and Amount of
Underlying Securities (Inst. 3 and 4) |
8. Price of
Derivative Security (Inst. 5) |
9. Number
of Derivative Securities Beneficially Owned at End of Year (Inst. 4) |
10.
Ownership of Derivative Security: Direct (D) or Indirect (I) (Inst. 4) |
11. Nature of Indirect Beneficial Ownership (Inst. 4) | |||
(A) |
(D) |
Date Exercisable |
Expiration Date |
Title |
Amount or Number of Shares |
||||||||
Explanation of Responses: * Common stock, valued at $30,000, was issued to Mr. Forigo in 1999 for payment of intellectual property valued at $7,500.
/S/ MAURIZIO FORIGO | 2/12/2003 |
**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. 788ff(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.