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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 | ||||||||
Common Stock Options | $ 0.1 | 11/07/2009 | P | 100,000 (1) | 11/07/2009(1) | 11/06/2019(1) | Common Stock | 100,000 | $ 0.1 | 1,425,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Sample Steven L 3512 E. SILVER SPRINGS BLVD - #243 OCALA, FL 34470 |
X | X | CEO & President |
/s/ Steven L Sample | 03/30/2010 | |
**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) | On 01/15/2010, Reporting Person reported the grant of 100,000 Common Stock Options as a result in error of communications. There was in fact no such grant of said options, which he reported with a grant date of 11/06/2009. This report is made to offset and correct the earlier incorrect report of grant or acquisition of those derivative securities and to correct the total number of derivative securities beneficially owned by the Reporting Person following the reported transactions. There was no such grant, and no accounting was made for any such grant in the Company's 2009 Annual Report 10-K. |
Remarks: See Footnote Number 1. Reporting Person submits this report to negate an earlier incorrect report of grant or award of Common Stock Options. Said incorrect report was filed on 01/15/2010 and referenced a grant date of 11/06/2009. There was no option grant to Reporting Person on that date or in that amount, and Reporting Person submits this information to correct the total number of derivative securities beneficially owned following this submission. Reporting Person also disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any other person in his securities. |