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OMB APPROVAL
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OMB Number 3235-0362
Expires: January 31, 2005
Estimated average burden
hours per response ....... 0.5
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U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 5
ANNUAL 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).
[_] Form 3 Holdings Reported
[_] Form 4 Transactions Reported
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1. Name and Address of Reporting Person*
Chitnis Shekhar Ramesh
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(Last) (First) (Middle)
91 Via Sonrisa
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(Street)
San Clemente CA 92630
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Liquidmetal Technologies (LQMT)
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
December 31, 2002
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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)
[X] Director [_] 10% Owner
[_] Officer (give title below) [_] Other (specify below)
_______________
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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. 6.
2A. 4. Amount of Owner-
Deemed Securities Acquired (A) or Securities ship
Execu- Disposed of (D) Beneficially Form: 7.
tion (Instr. 3, 4 and 5) Owned at End Direct Nature of
2. Date, 3. ---------------------------- of Issuer's (D) or Indirect
1. Transaction if any Transaction (A) Fiscal Year Indirect Beneficial
Title of Security Date (Month/ Code Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Day/Year) (Instr. 8) (D) and 4) (Instr.4)(Instr. 4)
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Liquidmetal Technologies
Common Stock 258,327 D
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Liquidmetal Technologies By minor
Common Stock 5,795 I child
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Liquidmetal Technologies By minor
Common Stock 5,795 I child
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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.
(Over)
(Form 3/99)
FORM 5 (continued)
Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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9. 10.
Number Owner-
of ship
2. Deriv- of
Conver- 5. 7. ative Deriv- 11.
sion Number of Title and Amount Secur- ative Nature
or 3A. Derivative 6. of Underlying 8. ities Secur- of
Exer- Deemed Securities Date Securities Price Bene- ity: In-
cise 3. Ex- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans- ecution 4. or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene-
1. of action Date, Trans- of (D) (Month/Day/Year) Amount ative at End In- ficial
Title of Deriv- Date if any action (Instr. 3, ---------------- or Secur- of direct Owner-
Derivative ative (Month/ (Month/ Code 4 and 5) Date Expira- Number ity Year (I) ship
Security Secur- Day/ Day/ (Instr. ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Year) 8) (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Liquidmetal
Option to Technologies
purchase Common
common stock $2.79 05/01/02 05/01/10 Stock 386,581 D
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Explanation of Responses:
/s/ Curt P. Creely February 14, 2003
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CURT P. CREELY AS ATTORNEY IN FACT FOR Date
SHEKHAR RAMESH CHITNIS
*** 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.