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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT 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 2270 (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 at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Options | $ 1 | 09/05/2012 | Â | J | 100,000 (2) | Â | 10/30/2013 | 10/30/2016 | Common Stock | $ 0 | 100,000 | Â | ||
Options | $ 3 | 09/05/2012 | Â | J | 200,000 (2) | Â | 10/30/2013 | 10/30/2016 | Common Stock | $ 0 | 300,000 | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HENSON STEVEN R. 7002 CLEARMEADOW CIRCLE WICHITA, KS 67205 |
 X |  |  CEO, President |  |
/s/ Steven R. Henson | 04/03/2013 | |
**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) | Pursuant to the Reporting Person's initial Corporate Officer Consulting Engagement Agreement ("Consulting Agreement") with the Issuer, the Reporting Person was entitled to receive a monthly issuance of 20,000 shares of common stock and 20,000 warrants to purchase common stock. Pursuant thereto, he received 20,000 shares of such common stock. Since receiving those shares, the Issuer and the Reporting Person agreed that he is only entitled to cash compensation under the Consulting Agreement and amended the agreement accordingly; however, they agreed he shall keep the shares already received. Additionally, the Reporting Person received 20,000 shares for board services provided to the Issuer. |
(2) | The transaction reported herein should have been previously reported on a Form 3, but were not. |
 Remarks: Other than as noted above and the shares noted as purchased in the open market, the remainder of the securities included herein represent shares issued to the Reporting Person for Board services rendered to the Issuer. |