UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Stock Options for Common Stock | Â (2) | 12/31/2019 | Common Stock | 140,000 | $ 0.64 | D | Â |
Convertible Promissory Note | Â (3) | 06/30/2013 | Common Stock | 500,000 | $ 1 | I | By TLC Investments, LLC (1) |
Warrant to Purchase Common Stock | Â (4) | 12/31/2014 | Common Stock | 600,000 | $ 0.65 | I | By Woodstone Energy, LLC (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Wilson Robert Jr. 1244 GALLATIN PIKE SOUTH MADISON, TN US 37115 |
 |  |  | Vice President of Subsidiary |
Robert E. Wilson | 01/11/2010 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Mr. Wilson owns a minority interest in this company. |
(2) | Granted under the 2008 Stock Incentive Plan; 25% exercisable on 12/31/2010, the remaining 75% exercisable monthly in equal amounts over next 36 months. |
(3) | This Note is convertible from 06/30/2010 to 06/30/2013. |
(4) | Exercisable as to 400,000 shares when $10 million in orders received, and as to 200,000 shares when $5 million additional orders received. |