OMB APPROVAL
OMB Number: 3235-0287
Expires: January 31, 2005
Estimated average burden
hours per response... .5






UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, DC 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(h) of the Investment Company Act of 1940

o Check this box if no longer
subject to Section 16.
Form 4 or Form 5
obligations may continue.
See Instruction 1(b).

1. Name and Address of Reporting
Person*

Drill Scott F           

2. Issuer Name and Ticker or
Trading Symbol

Insignia Systems, Inc. (ISIG)

3. I.R.S. Identification Number of Reporting
Person, if an entity (voluntary)

   
   
 
    (Last)       (First)       (Middle)

4. Statement for Month/Day/Year

February 20, 2003

5. If Amendment, Date of Original (Month/Year)

  6470 Sycamore Court North 
   
 
  (Street)
6. Relationship of Reporting Person(s)
to Issuer (Check All Applicable)
7. Individual or Joint/Group Filing
(Check One)
  Maple Grove MN 55369

City)                (State)           (Zip)

  x  Director o  10% Owner   x Form filed by One Reporting Person
    x  Officer (give title below)   o Form filed by More than One Reporting Person
    o  Other (specify below)
 
      President and CEO 
     

*   If the form is filed by more than one reporting person, see instruction 4(b)(v).

 

 


Table I — Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned

1. Title of Security
(Instr. 3)
2. Transaction Date
(Month/Day/Year)
2a. Deemed Execution
Date, if any.
(Month/Day/Year)
3. Transaction Code
(Instr. 8)


Code      ¦       V
4. Securities Acquired (A)
or Disposed of (D)
(Instr. 3, 4 and 5)
                  (A)
Amount   ¦   or    ¦    Price
                  (D)
5. Amount of Securities
Beneficially Owned
Following Reported
Transactions(s)
(Instr. 3 and 4)
6. Ownership
Form:
Direct (D) or
Indirect (I)
(Instr. 4)
7. Nature of
Indirect
Beneficial
Ownership
(Instr. 4)

   Common Stock   2/20/03   M   201,391   A $1.063          

   Common Stock   2/20/03   S   106,000   D $4.75     297,570     D  


Reminder:  Report on a separate line for each class of securities beneficially owned directly or indirectly.

Page 2

 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned
  (e.g., puts, calls, warrants, options, convertible securities)

1. Title of Derivative
Security
(Instr. 3)
2. Conversion or Exercise
Price of Derivative
Security
3. Transaction
Date
(Month/Day/Year)
3a. Deemed Execution Date,
if any.
(Month/Day/Year)
4. Transaction
Code
(Instr. 8)

   Code       ¦        V
5. Number of Derivative Securities
Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)

   (A)        ¦        (D)

   Non-Qualified Stock Option    $1.063    2/20/03        M         40,000

   Non-Qualified Stock Option    $1.063    2/20/03        M         30,000

   Non-Qualified Stock Option    $1.063    2/20/03        M         36,000

   Incentive Stock Option    $1.063    2/20/03        M         60,000

   Incentive Stock Option    $1.063    2/20/03        M         35,391

                            

                            

Page 3

 


Table II — Derivative Securities Acquired, Disposed of, or Beneficially Owned — Continued
(e.g., puts, calls, warrants, options, convertible securities)

6. Date Exercisable and
Expiration Date
(Month/Day/Year)

Date                Expiration
Exercisable   ¦   Date
7. Title and Amount
of Underlying Securities
(Instr. 3 and 4)
                  Amount or
                  Number of
Title     ¦     Shares
8. Price of Derivative
Security
(Instr. 5)
9. Number of Derivative
Securities Beneficially Owned
Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of
Derivative Securities
Beneficially Owned
at End of Month
11. Nature of
Indirect
Beneficial
Ownership
(Instr. 4)

  8/24/98 2/24/03   CS 40,000          

  9/24/98 2/24/03   CS 30,000        

  2/24/01 2/24/03   CS 36,000        

  8/24/98 2/24/03   CS 30,000        

  2/24/01 2/24/03   CS 35,391     125,000   D  

           

           

Explanation of Responses:

/s/ Scott Drill   2/21/03

**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 is insufficient, see Instruction 6 for procedure.
 

Page 4