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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 Purchase Warrant | $ 0.5 | 11/23/2012 | G | 125,000 | (4) | (4) | Common Stock | 125,000 | $ 0 | 2,500,000 | I | Member of Associated Private Equity LLC (1) | |||
Additional Investment Right (right to buy) (2) | (2) | 11/23/2012 | G | 0 (2) | (3) | (3) | Common Stock | (2) | $ 0 | 0 (2) | I | Member of Associated Private Equity LLC (1) | |||
10% Convertible Preferred Stock | (5) | 11/23/2012 | G | 5 | (5) | (5) | Common Stock | 125,000 | $ 0 | 100 | I | Member of Associated Private Equity LLC (1) | |||
Additional Investment Right (right to buy) (2) | (2) | 03/19/2013 | C | 0 (6) | (3) | (3) | Common Stock | (2) | (2) | 0 | I | Member of Associated Private Equity LLC (1) | |||
10% Convertible Preferred Stock | (5) | 03/19/2013 | A | 33.3333 | (5) | (5) | Common Stock | 833,333 | (5) | 133.3333 | I | Member of Associated Private Equity (1) | |||
Common Stock Purchase Warrants | $ 0.5 | 03/19/2013 | A | 833,333 | (7) | (7) | Common Stock | 833,333 | $ 0 | 833,333 | I | Member of Associated Private Equity LLC (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
BRAVERMAN NEIL K 4454 WAYSIDE DRIVE NAPLES, FL 34119 |
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/s/ Charles F. Coppa, as attorney in fact | 03/27/2013 | |
**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 reported securities are owned directly by Associated Private Equity LLC, which Mr. Braverman is a member, and Mr. Braverman disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
(2) | The Additional Investment Right ("AIR") was granted by the issuer to Associated Private Equity, LLC ("Associated"), in connection with Associated's investment in the issuer. Mr. Braverman is a member of Associated. The AIR permits the holder to purchase additional investment units with each unit comprised of one share of 10% Convertible Preferred Stock (the "Preferred Stock") and a warrant exercisable for 25,000 shares of Common Stock (the "Warrants"). The Preferred Stock is convertible into Common Stock at a conversion price of $.40 per share, and the Warrants are exercisable for Common Stock at an exercise price of $.50 per share. Pursuant to the terms of the AIR, Associated initially had the right to acquire up to 35 shares of Preferred Stock convertible into 875,000 shares of Common Stock and Warrants exercisable to purchase 875,000 shares of Common Stock. On November 23, 2012, Associated transferred as a gift 4.76% of the AIRs it held. |
(3) | The AIR is exercisable from April 30, 2012 to March 31, 2013. |
(4) | The Warrants are first exercisable on October 30, 2012 and expire on October 30, 2017. |
(5) | The Preferred Stock is convertible at any time, at the holder's election, and has no expiration date. Each share of Preferred Stock has a fair value of $10,000 and is convertible into shares of Common Stock at a conversion price of $.40 per share. |
(6) | Associated exercised 100% of the AIR owned by it on March 19, 2013 in order to acquire 33.3333 shares of Preferred Stock and a warrant to purchase 833,333 shares of Common Stock. |
(7) | The Warrants are first exercisable on September 19, 2013 and expire on September 19, 2018. |