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 | ||||
Warrants (Rights to buy Common Stock) | 10/26/2005 | 10/26/2012 | Common Stock | 1,500,000 (1) | $ 0.004 (1) | D (2) | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sigma Capital Advisors, LLC 800 THIRD AVENUE SUITE 1701 NEW YORK, NY 10022 |
 |  X |  |  |
Sigma Capital Partners, LLC 800 THIRD AVENUE NEW YORK, NY 10022 |
 |  X |  |  |
Waye Thom C/O SIGMA CAPITAL ADVISORS, LLC 800 THIRD AVENUE NEW YORK, NY 10022 |
 |  X |  |  |
Sigma Capital Advisors, LLC, By: /s/Thom Waye, Manager | 11/07/2005 | |
**Signature of Reporting Person | Date | |
Sigma Capital Partners, LLC, By: /s/Thom Waye, Sole Member | 11/07/2005 | |
**Signature of Reporting Person | Date | |
/s/Thom Waye | 11/07/2005 | |
**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) | The number of shares and the exercise price reflects the one-for-four reverse stock split effected by Omni Medical Holdings, Inc. on November 4, 2005. |
(2) | Filed jointly by Sigma Capital Advisors, LLC ("Sigma Advisors"), Sigma Capital Partners, LLC ("Sigma Partners") and Thom Waye. 1,218,750 of the securities reported are owned directly by Sigma Opportunity Fund, LLC and owned indirectly by Sigma Advisors by virtue of it being the managing member of Sigma Opportunity Fund, LLC and by Sigma Partners by virtue of it being the sole member of Sigma Advisors and by Mr. Waye by virtue of his position as the sole member of Sigma Partners. 281,250 of the securities reported are owned directly by Sigma Advisors and owned indirectly by Sigma Partners by virtue of it being the sole member of Sigma Advisors and by Mr. Waye by virtue of his position as the sole member of Sigma Partners. Mr. Waye, Sigma Partners and Sigma Advisors disclaim beneficial ownership of the shares owned by Sigma Opportunity Fund, LLC except to the extent of their pecuniary interest therein. |