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 | ||||
Option (right to buy) (1) | 07/24/2006 | 07/24/2016 | Common Stock | 44,444 | $ 6.93 | D | Â |
Warrant (right to buy) | 12/31/2002 | 12/12/2012 | Common Stock | 14,159 | $ 3.18 | D | Â |
Series E Preferred Stock | Â (2) | Â (2) | Common Stock | 94,398 (2) | $ (2) | I | By the E. C. Boden Living Trust Established September 18, 1992 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Boden Eric J C/O HIRERIGHT, INC. 5151 CALIFORNIA AVENUE IRVINE, CA 92617 |
 X |  X |  President and CEO |  |
/s/ Jason R. Wisniewsk, as Attorny in Fact for Eric J. Boden | 08/07/2007 | |
**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) | Granted pursuant the HireRight, Inc. 2000 Stock Option/Stock Issuance Plan. |
(2) | The Series E Preferred Stock is immediately convertible into HireRight, Inc. common stock and has no expiration date. Effective upon the closing of the issuer's initial public offering of common stock, the Series E Preferred Stock will automatically convert into the number of shares of common stock of HireRight, Inc. indicated in column 3. |