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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 | ||||||||
Series A Preferred Stock | $ 0.2 | 04/03/2009 | P | 350,000 | 04/03/2009 | (4) | Common Stock | 1,750,000 | $ 1 | 350,000 | I | See Footnote 1 (1) | |||
Common Stock Warrants | $ 0.25 | 04/03/2009 | J(1) | 437,500 | 04/03/2009 | 04/03/2014 | Common Stock | 437,500 | (2) | 1,386,850 | I | See footnote 2 (2) | |||
Common Stock Options | $ 0.18 | 06/02/2009 | J(2) | 283,063 | 12/31/2007 | 12/31/2011 | Common Stock | 283,063 | (3) | 370,159 | I | See footnote 3 (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Tyson John E P O BOX 306 CRYSTAL BAY, NV 89402 |
X | X |
/s/ John E. Tyson | 06/02/2009 | |
**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) | The Series A Preferred Stock is owned by Amerivon Investments LLC. Amerivon Investments LLC is an affiliate of Mr. Tyson. |
(2) | Common Stock Warrants received on April 3, 2009 were issued to purchasers of Series A Preferred Stock. The number of Common Stock Warrants beneficially owned following this transaction includes 949,350 shares of common stock underlying currently exercisable warrants priced at $0.53 with an expiration date of 7/1/2009. The Common Stock Warrants are owned by Amerivon Investments LLC. Amerivon Investments LLC is an affiliate of Mr. Tyson. |
(3) | The Common Stock Options were transferred for no consideration to an entity that is not an affiliate of aVinci Media Corporation. The Common Stock Options are owned by Amerivon Investments LLC. Amerivon Investments LLC is an affiliate of Mr. Tyson. |
(4) | There is no expiration date |
(5) | 17,429,640 shares owned of record by Amerivon Investments LLC, which is an affiliate of Mr. Tyson. The total in Box 5 does not include 58,323 shares owned directly by Mr. Tyson |