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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 | |
DOUGLAS KEVIN 125 E. SIR FRANCIS DRAKE BLVD., STE 400 LARKSPUR, CA 94939 |
X | |||
Douglas Michelle 125 E. SIR FRANCIS DRAKE BLVD., STE 400 LARKSPUR, CA 94939 |
X | |||
DOUGLAS FAMILY TRUST 125 E. SIR FRANCIS DRAKE BLVD., STE 400 LARKSPUR, CA 94939 |
X | |||
JAMES & JEAN DOUGLAS IRREVOCABLE DESCENDANTS TRUST 125 E. SIR FRANCIS DRAKE BLVD., STE 400 LARKSPUR, CA 94939 |
X | |||
DOUGLAS JAMES E III 125 E. SIR FRANCIS DRAKE BLVD., STE 400 LARKSPUR, CA 94939 |
X |
/s/ Tim McGaw, attorney in fact for Kevin Douglas | 03/24/2011 | |
**Signature of Reporting Person | Date | |
/s/ Tim McGaw, attorney in fact for Michelle Douglas | 03/24/2011 | |
**Signature of Reporting Person | Date | |
/s/ Tim McGaw, attorney in fact for Douglas Family Trust | 03/24/2011 | |
**Signature of Reporting Person | Date | |
/s/ Tim McGaw, attorney in fact for James Douglas and Jean Douglas Irrevocable Descendants' Trust | 03/24/2011 | |
**Signature of Reporting Person | Date | |
/s/ Tim McGaw, attorney in fact for James E. Douglas III | 03/24/2011 | |
**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) | These shares are held directly and jointly by Kevin Douglas and Michelle Douglas, husband and wife. |
(2) | The reporting persons are filing this Form 4 jointly, but not as members of a group, and each expressly disclaims membership in a group. The filing of this Form 4 should not be construed as an admission that any reporting person is, and each such person disclaims that that such person is, the beneficial owner, as defined in Rule 13d-3 under the Securities Exchange Act of 1934, as amended, of any of the securities covered by this Form 4, except for securities that such person holds directly. |
(3) | These shares are held directly by the James Douglas and Jean Douglas Irrevocable Descendants' Trust and indirectly by Kevin Douglas and Michelle Douglas as co-trustees of the James Douglas and Jean Douglas Irrevocable Descendants' Trust. |
(4) | These shares are held directly by the Douglas Family Trust and indirectly by Kevin Douglas, James E. Douglas, Jr. and Jean A. Douglas, husband and wife, as co-trustees of the Douglas Family Trust. |
(5) | These shares are held direcly by James E. Douglas III and indirectly by Kevin Douglas. |