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 | ||||
10% PIK-Election Convertible Note (1) | Â (2) | 12/15/2018 | Common Stock | 142,857 | $ 0.35 (2) | D | Â |
Stock Option Right to Purchase | Â (3) | 01/01/2019 | Common Stock | 6,966,419 (3) | $ 0.7 (3) | I | Material Advisors LLC (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Zeitoun Andre 630 EAST MULLAN AVE. #D OSBURN, ID 83849 |
 X |  |  President and CEO |  |
/s/ Andre Zeitoun | 01/09/2009 | |
**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) | The Note has a principal amount of $50,000 and is convertible into 142,857 shares of Common stock at $.35 per share. |
(2) | The Note has a maturity date od Decmber 15, 2018. At the holder's option, amounts outstanding under the Note may be converted into common stock at any time after the Company has authorized sufficient shares to convert such amounts outstanding into common stock at the conversion price of $.35 per share (the "Conversion Price"). The amount outstanding shall be mandatorily converted into common stock of the Company at the Conversion Price upon (i) the Company's authorization of a sufficient number of shares to convert amounts outstanding under all of the series of 10% PIK-Election Convertible notes into common stock, (ii) the average market price for the Common Stock is in excess of the Conversion Price and (iii) either (a) the Company has filed and caused to become effective a registration statement for the resale of the number of shares of common stock into which the outstanding amount under the note is convertible, or (b) such shares are resaleable under Rule 144. |
(3) | The Stock Option was granted to Material Advisors LLC effective January 1, 2009 pursuant to a Management Agreement dated December 30, 2008 with the Company, pursuant to which Material Advisors will perform senior management services for the Company. The option will vest in 36 equal monthly installments over 3 years. Andre Zeitoun is the manager and majority owner of Material Advisors LLC. This filing will not be deemed an admission that Andre Zeitoun is a beneficial owner of the entire amount of equity securities covered by this filing and he disclaims beneficial ownership of those equity securities subject to the option in excess of his original ownership percentage in Material Advisors LLC. |