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Form 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION |
OMB APPROVAL |
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Check box if no longer subject to Section 16, Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
Washington, DC 20549 |
OMB NUMBER: 3235-0362 |
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Form 3 Holdings Reported |
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 |
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Form 4 Transactions Reported |
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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 |
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Brass Eagle Inc. (XTRM) |
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Dowd, Anthony J. |
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X Director 10% Owner |
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(Last) (First) (Middle) |
3. I. R. S. Identification Number of Reporting |
4. Statement for Month/Year |
Officer (give title below) Other (specify below) |
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Person, if an entity (Voluntary) |
2001 |
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10 Old Tavern Road |
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(Street) |
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5. If Amendment, Date of |
7. Individual or Joint/Group Reporting |
Newton, CT 06470 |
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Original (Month/Year) |
(check applicable line) |
(City) (State) (Zip) |
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X Form Filed by one Reporting Person |
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Form Filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security |
2. Trans-action Date |
3. Trans-action |
4. Securities Acquired (A) or Disposed of (D) |
5. Amount of Securities Beneficially |
6. Owner-ship Form: |
7. Nature of Indirect |
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(Instr.3) |
(Month/Day/Year) |
Code (Instr.8) |
(Instr. 3, 4 and 5) |
Owned at the end of Issuer's Fiscal Year |
Direct (D) or Indirect |
Beneficial Ownership |
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Amount |
(A) or (D) |
Price |
(Instr. 3 and 4) |
(I) (Instr. 4) |
(Instr.4) |
Brass Eagle Inc. |
1/08/01 |
A |
262 |
A |
* |
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Common Stock |
4/09/01 |
A |
238 |
A |
* |
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7/06/01 |
A |
217 |
A |
* |
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10/02/01 |
A |
359 |
A |
* |
3,589 |
D |
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3,674,474 |
I |
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* Given to reporting person as compensation for serving on Board of Directors. |
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* 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 |
2. Conver-sion |
3. Trans- |
4. Trans- |
5. Number of |
6. Date Exercisable and |
7. Title and Amount of |
8. Price of |
9. Number of |
10. Ownership |
11. Nature |
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Derivative |
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action |
action |
Derivative Securities |
Expiration Date |
Underlying Securities |
Derivative |
Derivative |
Derivative |
of Indirect |
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Security |
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Date |
Code |
Acquired (A) or |
(Month/Day/Year) |
(Instr. 3 and 4) |
Security |
Securities |
Security: Direct |
Beneficial |
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(Instr. 3) |
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(Month/ |
(Instr.8) |
Disposed of (D) |
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(Instr.5) |
Beneficially |
(D) or Indirect |
Ownership |
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Day/Year) |
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Owned at End |
(I) |
(Instr.4) |
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(Instr. 3, 4 and 5) |
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of Year |
(Instr.4) |
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Amount |
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(Instr. 4) |
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or |
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Date |
Expiration |
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Number |
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(A) |
(D) |
Exercisable |
Date |
Title |
of Shares |
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Explanation of Responses:
/s/ Anthony J. Dowd |
2/13/02 |
** 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.