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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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
James JayCee 9298 SVL BOX VICTORVILLE, CA 92395 |
X | Majority Holder |
JayCee James | 04/10/2009 | |
**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) | Establishment of the Capital Source Healthcare REIT discriminatory share price, the reporting owner has determined to issue as previously filed in the SEC Form 4, 5,000,000 preferred stock upon the completion of Capital Source Healthcare REIT (CHR) corporate restructuring notwithstanding all like Communications industry comparable share structures and share prices. |
(2) | Establishment of the Capital Source Healthcare REIT discriminatory share price, the reporting owner has determined to issue as previously filed in the SEC Form 4, 42,105,000 common stock upon the completion of Capital Source Healthcare REIT (CHR) corporate restructuring notwithstanding all like Communications industry comparable share structures and share prices. |
Remarks: All Common shares and Preferred shares if applicable currently outstanding listed as 42,105,000 common on NYSE under Ticker Symbol CHR and all other exchanges & trading markets As of Apr 10, 2009 notwithstanding Form 3 filed April 10, 2009 and subsequently Form 3A filed April 10, 2009 shall be transferred to majority holder and ownership listed with all Market Makers and Transfer Agents including proper book entry as permitted in the most current filing. As used herein, the term own includes legal ownership, but in all cases includes beneficial ownership more than 50% of whose equity interests are beneficially owned. According to SEC Forms 3, 3/A filed on 4/10/2009, Control is deemed to exist as permitted under 13d-4 of SEC 34 I expressly declare that the current filing shall be construed as an admission that such person is for the purposes of Sections 13(d) or 13(g) the beneficial owner of any securities covered by the filings defined for these purposes. |