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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES 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 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
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) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
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 Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Convertible Note (3) | $ 0.1 | (3) | (3) | Common Shares | 7,000,000 | 7,000,000 | D | ||||||||
Convertible Note (4) | $ 0.05 | (4) | (4) | Common Shares | 6,000,000 | 6,000,000 | D | ||||||||
Convertible Note (2) | $ 0.0444 | 06/24/2011 | C | 3,421,000 | (2) | (2) | Common Shares | 3,421,000 | (2) | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DICKEY WILLIAM S 6130 S. ELM CT. CENTENNIAL, CO 80121 |
X |
William S. Dickey | 07/14/2011 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | On February 3, 2010 the Issuer issued 600,000 shares to Mr. Dickey for financial services performed. |
(2) | On June 24, 2011, the Issuer and Mr. Dickey entered into a debt settlement and subscription agreement wherein Mr. Dickey agreed to subscribe for 3,421,000 shares of common stock of the Issuer at a purchase price of $0.04445 per share, or $152,065.28, exercisable on demand. In lieu of a cash payment to the Issuer, the shares of common stock were issued to Mr. Dickey as payment of an outstanding debt owed to Mr. Dickey in the amount of $152,065.28 as full payment of the debt owed. |
(3) | The Convertible Note was issued pursuant to a debt conversion agreement dated February 1, 2009 in the amount of $700,000. The proceeds are payable on demand. |
(4) | The Convertible Note was issued pursuant to the balance of a debt conversion agreement dated November 6, 2009 in the amount of $300,000. The proceeds are payable on demand. |