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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 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 Warrants | $ 1 (2) | 12/08/2004 | X | 500,000 | 05/17/2003 | 05/17/2008 | Common Stcok | 500,000 | $ 0 | 0 | D | ||||
Common Stock Purchase Warrants | $ 0.50 (2) | 12/08/2004 | X | 100,000 | 05/17/2003 | 05/17/2008 | Common Stock | 100,000 | $ 0 | 0 | D | ||||
Common Stock Purchase Warrants (2) | $ 1.50 | 12/08/2004 | A | 120,000 | 11/23/2004 | 11/23/2007 | Common Stock | 120,000 | $ 0 | 120,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
WENNINGER RICHARD E C/O WENNINGER COMPANIES 855 WEST DEAN ROAD MILWAUKEE, WI 53217 |
X | X |
James M. Bedore, Attorney-in-Fact | 12/08/2004 | |
**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) | Mr. Wenninger also owns indirectly: 5,000 shares are held by Mr. Wenninger's spouse (Mr. Wenninger disclaims beneficial ownership of these shares); and 250,000 shares are held in a trust as to which Mr. Wenninger is a trustee and beneficiary. |
(2) | Each common stock purchase warrant was originally convertible into one share of common stock upon payment of the per warrant exercise price. The conversion rate was subsequently amended to grant the holder of the warrants an additional number of common stock purchase warrants upon conversion equal to 20% of the aggregate number of common stock purchase warrants exercised. As a result, because the holder of the warrants exercised a total of 600,000 common stock purchase warrants, the holder received an additional 120,000 common stock purchase warrants. |