U.S. SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 4
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 of Section 16. Form 4 or Form 5 obligations
may continue. See Instruction 1(b).
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1. Name and Address of Reporting Person*
Norell Richard V.
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(Last) (First) (Middle)
602 Enterprise Drive
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(Street)
Kingston NY 12401
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(City) (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
Image Technology Laboratories, Inc. IMTL
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3. IRS Identification Number of Reporting Person, if an Entity (Voluntary)
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4. Statement for Month/Year
January 14, 2003
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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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6.
4. 5. Owner_
Securities Acquired (A) or Amount of ship
3. Disposed of (D) Securities Form: 7.
Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of
2. Code _______________________________ Owned at End (D) or Indirect
1. Transaction (Instr. 8) (A) of Month Indirect Beneficial
Title of Security Date ____________ Amount or Price (Instr. 3 (I) Ownership
(Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4)
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Common Shares 01/14/03 P 5,000 A $0.22 173,000 D
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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.
(Print or Type Responses)
(Over)
(Form 4_07/99)
FORM 4 (continued)
Table II __ Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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10.
9. Owner_
Number ship
of Form
2. Deriv_ of
Conver_ 5. 7. ative Deriv_ 11.
sion Number of Title and Amount Secur_ ative Nature
or Derivative 6. of Underlying 8. ities Secur_ of
Exer_ 4. Securities Date Securities Price Bene_ ity: In_
cise 3. Trans_ Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct
Price Trans_ action or Disposed Expiration Date ________________ Deriv_ Owned (D) or Bene_
1. of action Code of(D) (Month/Day/Year) Amount ative at End In_ ficial
Title of Deriv_ Date (Instr. (Instr. 3, ________________ or Secur_ of direct Owner_
Derivative ative (Month/ 8) 4 and 5) Date Expira_ Number ity Month (I) ship
Security Secur_ Day/ ______ ____________ Exer_ tion of (Instr. (Instr. (Instr. (Instr.
(Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4)
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Warrants $0.50 10/15/00 P A 10,000 4/15/03 common 10,000 10,000 D D
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Explanation of Responses:
/s/ Richard V. Norell January 16, 2003
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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.
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