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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 | ||||||||
Warrants (right to buy) (1) | $ 1 | 03/16/2009 | A | 20,000 | 03/16/2009 | 03/16/2014 | Common | 20,000 | $ 0 | 20,000 (1) | D | ||||
Warrants (right to buy) (1) | $ 1 | 04/18/2009 | A | 80,000 | 04/18/2009 | 04/18/2014 | Common | 80,000 | $ 0 | 80,000 (1) | D | ||||
Warrants (right to buy) (1) | $ 1 | 04/29/2009 | A | 50,000 | 04/29/2009 | 04/29/2014 | Common | 50,000 | $ 0 | 50,000 (1) | D | ||||
Warrants (right to buy) (1) | $ 1 | 05/18/2009 | A | 100,000 | 05/18/2009 | 05/18/2014 | Common | 100,000 | $ 0 | 100,000 (1) | D | ||||
Warrants (right to buy) (1) | $ 1 | 06/01/2009 | A | 53,200 | 06/01/2009 | 06/01/2014 | Common | 53,200 | $ 0 | 53,200 (1) | D | ||||
Series B Convertible Preferred Stock | $ 0 (2) | 09/28/2009 | P | 40,000 | 09/28/2009 | (3) | Common | 400,000 | $ 5 | 40,000 | D | ||||
Series B Convertible Preferred Stock | $ 0 | 01/13/2010 | P | 20,000 | 01/13/2010 | (3) | Common | 200,000 | $ 5 | 60,000 | D | ||||
Options (right to buy) | $ 1.95 | 01/13/2010 | A | 75,000 | (4) | 01/13/2014 | Common | 75,000 | $ 0 | 75,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Naydenov Jordan G 20533 SE EVERGREEN HWY CAMAS, WA 98607 |
X |
Jordan Naydenov | 10/31/2011 | |
**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) | The previously reported warrants contained various scrivener's errors: The warrants were acquired on various dates with varying expiration dates, all acquired prior to the date the reporting person was required to report his holdings and should have been reported as of 07/01/2009. |
(2) | The previously reported Series B Convertible Preferred Stock contained a scrivener's error: The Conversion or Exercise Price of the Derivative securities should have been $0. |
(3) | None. |
(4) | The options vested beginning 02/13/2010 in 36 equal monthly installments. |