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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Pertile Richard K 13575 58TH STREET NORTH - #138 CLEARWATER, FL 33760 |
X | CEO, President |
/s/ Richard K. Pertile by Steven L. Sample, PoA | 05/11/2016 | |
**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) | Reporting Person acquired 20,000 shares of the Issuer's restricted Common stock in a private transaction. |
(2) | Following this transaction the Reporting Person owned a total of 1,034,000 shares of the Issuer. Through a scrivener's error, Reporting Person had previously reported that it owned 960,000 shares of Issuer gained in the Issuer's acquisition transactions of January 15, 2016, but the number of shares actually issued to Reporting Person in those transactions was 1,014,000 bringing the new total to 1,034,000. |
Remarks: Reporting Person also has a proxy from the Issuer's ex-CEO, Steven L. Sample, to vote 2,500,000 Common shares of Issuer. Reporting Person holds a right of first refusal to purchase those shares during a two month window occurring in 2019. |