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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 | ||||||||
Warrants | $ 0.2 | 10/31/2009 | A(3) | 500,000 | 10/31/2009 | 10/31/2014 | Common Stock | 500,000 | $ 0.2 | 500,000 | D | ||||
Options (4) | $ 0.385 | 02/06/2009 | 02/06/2019 | Common Stock | 225,000 | 225,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Bauer Roy A. N6654 STATE HWY 25 DURAND, WI 54736 |
X | President |
Roy A. Bauer | 02/23/2010 | |
**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) | These shares were acquired in lieu of cash reflecting the payment of $109,375.05 in accrued wages due to Mr. Bauer by the Company as of September 30, 2009. |
(2) | These shares were acquired in lieu of cash reflecting the payment of $21,847.80 in accrued wages due to Mr. Bauer by the Company for the months of October, November and December, 2009. |
(3) | On October 30, 2009, the Board of Directors approved that Mr. Bauer be given a signing bonus of 500,000 Warrants at $0.20 per Warrant effective February 9, 2009. |
(4) | On February 6, 2009, the Board of Directors of the Company granted Mr. Bauer the option to acquire 225,000 shares, with a three year vesting, at an exercise price of $0.385 per share, with a ten year term, as previously reported. |