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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 | ||||||||
Series B Convertible Preferred Stock (1) (2) | $ 0.02 | 08/19/2010 | P | 100,000 | (2) | (2) | Common Stock | 5,000,000 | (1) | 100,000 | I | By LLLP | |||
Common Stock Warrants (right to buy) (1) | $ 0.06 | 08/19/2010 | P | 2,500,000 | 08/19/2010 | 08/19/2013 | Common Stock | 2,500,000 | (1) | 2,500,000 | I | By LLLP | |||
Stock Options (right to buy) | $ 0.27 | 08/19/2010 | D(3) | 555,556 | (4) | (4) | Common Stock | 555,556 | (3) | 0 | D | ||||
Stock Options (right to buy) | $ 0.035 | 08/19/2010 | A(3) | 555,556 | (4) | (4) | Common Stock | 555,556 | (3) | 555,556 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Feirstein Douglas 200 E. BROWARD BLVD., SUITE 1200 FT. LAUDERDALE, FL 33301 |
X | See Remarks |
/s/ Douglas Feirstein | 08/19/2010 | |
**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 reported securities are included within one Unit purchased by the reporting person for $100,000 per Unit. Each Unit consists of 100,000 shares of Series B Convertible Preferred Stock and 2,500,000 warrants to purchase shares of common stock. |
(2) | These securities are convertible into the issuer's common stock at any time after the issuer increases its authorized capital. At such time, each share of the Series B Preferred Stock will be convertible into 50,000 shares of the issuer's common stock. The securities have no expiration date. |
(3) | The reported transactions involved an amendment of an outstanding option, resulting in the deemed cancellation of the "old" option and the grant of a replacement option. |
(4) | The expiration and the vesting terms remain the same as originally granted. |
Remarks: The reporting person is the Chief Executive Officer and a member of a 13(d) group owning more than 10%. |