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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 to Purchase Common Stock | $ 0.75 | 01/31/2015 | 01/31/2015 | C(1) | 12,562 | 01/31/2015 | 06/30/2016 | Common Stock | 6,281 | $ 0 | 6,281 | D | |||
Warrants to Purchase Common Stock | $ 1.5 | 01/31/2015 | 01/31/2015 | C(2) | 200,000 | 01/31/2015 | 12/31/2020 | Common Stock | 200,000 | $ 0 | 200,000 | D | |||
Options (Right to Buy) | $ 0.75 | 02/10/2015 | 02/10/2015 | J(3) | 150,000 | 02/10/2015 | 12/31/2020 | Common Stock | 150,000 | $ 0 | 150,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SMITH MARK A BOX 566 CRESTONE, CO 81131 |
X | X | President |
/s/ Mark A. Smith | 02/13/2015 | |
**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 January 31, 2015, Mr. Smith converted $6,280.55 of his deferred compensation into 12,562 Units of the Company's private placement, each consisting of one share of common stock and a callable warrant to purchase one-half share of common stock at $.75 per share until June 30, 2016. |
(2) | On January 31, 2015, Mr. Smith converted $90,000 of his convertible note into 200,000 shares of common stock and 200,000 warrants exercisable at $1.50 per share until December 31, 2020. |
(3) | These options were granted pursuant to an Extension Agreement relating to Mr. Smith's employment approved by the Board on February 10, 2015. |