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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 | ||||||||
Warrants | $ 1.75 | 07/28/2015 | G | 92,571 | 12/18/2012 | 12/18/2016 | Common Stock | 92,571 | (1) | 0 | I | See footnote (4) | |||
Warrants | $ 2 | 07/28/2015 | G | 92,571 | 12/18/2012 | 12/18/2016 | Common Stock | 92,571 | (1) | 0 | I | See footnote (4) | |||
Warrants | $ 1.75 | 07/28/2015 | G | 81,000 | 11/08/2012 | 11/08/2015 | Common Stock | 81,000 | (1) | 0 | I | See footnote (4) | |||
Promissory Note | $ 0.25 | 09/30/2015 | C | 1 | 04/01/2015 | 09/30/2015 | Common Stock | 540,000 | (5) | 1 | I | See footnote (4) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DULIN ROBERT KENNETH 8449 GREENWOOD DRIVE NIWOT, CO 80503 |
X |
/s/ Robert Kenneth Dulin | 10/06/2015 | |
**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) | Bona fide gift. |
(2) | Mr. Dulin is the trustee or custodian of certain trust/custodial accounts. All the beneficiaries of these accounts are members of Mr. Dulin's immediate family. Accordingly, the pecuniary interest of these immediate family members is attributed to Mr. Dulin. |
(3) | As of January 22, 2013, these trust/custodial accounts held 209,500 shares. Subsequently, and prior to this transaction, in connection with a beneficiary of these accounts reaching the age of 21 (which beneficiary is a family member of Mr. Dulin that does not share his household), Mr. Dulin ceased to be trustee or custodian of a total of 14,700 shares. |
(4) | This transaction was effected by Sawtooth Properties, LLLP ("Sawtooth"). Mr. Dulin is the Managing Partner of Sawtooth and holds a 90% pecuniary interest in securities held by Sawtooth. The amount of securities reported in this transaction represents Mr. Dulin's 90% pecuniary interest in the shares of common stock acquired or disposed of by Sawtooth. |
(5) | Conversion of promissory note. |