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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 | ||||||||
Warrant - right to buy (3) | $ 4.5 | 04/21/2005 | P | 2,000 | 04/05/2005 | 04/05/2010 | Common Stock | 2,000 | (4) | 8,000 (5) | I | See footnote (2) | |||
Warrant - right to buy (3) | $ 6 | 04/21/2005 | P | 2,000 | 04/05/2005 | 04/05/2010 | Common Stock | 2,000 | (4) | 10,000 (5) | I | See footnote (2) | |||
Warrant - right to buy (3) | $ 4.5 | 04/22/2005 | P | 2,000 | 04/05/2005 | 04/05/2010 | Common Stock | 2,000 | (4) | 12,000 (5) | I | See footnote (2) | |||
Warrant - right to buy (3) | $ 6 | 04/22/2005 | P | 2,000 | 04/05/2005 | 04/05/2010 | Common Stock | 2,000 | (4) | 14,000 (5) | I | See footnote (2) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Mathis Family Partners Ltd. 480 S HOLLY STREET DENVER, CO 80246 |
X | CEO |
/s/ Earnest Mathis Jr. | 04/25/2005 | |
**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 shares of common stock are part of Units with each Unit comprised of 2 shares of common stock and 1 warrant to purchase 1 share of common stock at $4.50 per share and 1 warrant to purchase 1 share of common stock at $6.00 per share. |
(2) | The Reporting Person is the General Partner of Mathis Family Partners, Ltd. and also the Custodian of Earnco MPPP that owns 55,342 shares of common stock and is the custodian for minor child that owns 600 shares of common stock. |
(3) | The Warrant is a part of Units with each Unit comprised of 2 shares of common stock and 1 warrant to purchase 1 shares of common stock at $4.50 per share and 1 warrant to purchase 1 share of common stock at $6.00 per share. |
(4) | The price of all the Warrants is included in the price of the Units comprised of common stock and warrants. |
(5) | The Reporting Person is the General Partner of Mathis Family Partners, Ltd. and also the Custodian of Earnco MPPP that owns options to purchase 23,000 shares of common stock which are not included in the total number of derivative securities reported to be beneficially owned by the Reporting Person |