FORM 5 |
UNITED STATES SECURITIES AND |
OMB APRIVAL |
OMB Number: 3235-0362 |
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility |
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2. Issuer Name and Ticker or Trading Symbol CRCWA |
4. Statement for (Month/Year) |
6. Relationship of Reporting Person to Issuer X Officer (Give title below) Other (Specify below) Jacqueline R. Danforth is the President and Treasurer of Capital Reserve Corporation. |
3. Social Security Number |
December, 2001 |
TABLE I - Non Derivative Securities Acquired, Disposed of or Beneficially Owned. |
1. Title of Security |
2. Transaction |
3. Transaction |
4. Securities Acquired (A) or Disposed of (D) |
5. Amount of Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 3 and 4) |
6. Ownership Form: |
Beneficial Ownership |
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Amount |
(A) or (D) |
Price |
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Common Stock |
12/17/01 |
J |
35,000 |
D |
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Common Stock |
12/24/01 |
J |
35,000 |
A |
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310,167** |
309,167 |
These shares are owned by Argonaut Management Group Inc. of which Ms. Danforth is the sole owner. |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. |
(Over) |
TABLE II - Derivative Securities Acquired, Disposed of or Beneficially Owned |
1. Title of Derivative (Instr.3) |
2.Conversion or Exercise |
3. Transaction Date |
4.Transaction Code |
5. Number of Derivative |
6. Date Exercisable and |
7. Title and Amount of Underlying |
8. Price of |
9. Number of Derivative |
10. Ownership |
11. Nature of |
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(A) |
(D) |
Date |
Expiration |
Title |
Amount or |
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Explanation of Responses:
* The warrants were included with the purchase of shares reported in Table I.
** This amendment is being filed to connect only the amount of securities reported in columns 5&6 of Table I as the result of an amendment to the reporting person's October 2001 Form 4.
/s/ Jacqueline R. Danforth February 14, 2002 |
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Signature of Reporting Person Date |
** Intentional missstatements or omissions of facts constitute Federal Criminal Violations
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).