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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 | ||||||||
Class A-2 Warrants (right to buy) | $ 3 | 11/01/2013 | M | 150,000 | 05/13/2009 | 05/13/2019 | Common Stock | 150,000 | $ 0 (2) | 0 | D | ||||
Class A-2 Warrants (right to buy) | $ 3 | 11/01/2013 | M | 50,000 | 06/30/2009 | 06/30/2019 | Common Stock | 50,000 | $ 0 (3) | 33,333 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
10X Fund, L.P. 1099 FOREST LAKE TERRACE NICEVILLE, FL 32578 |
X | |||
10X Capital Management, LLC 1099 FOREST LAKE TERRACE NICEVILLE, FL 32578 |
X |
/s/ James C. Czirr, as Managing Member of the General Partner for 10X Fund, LP | 11/05/2013 | |
**Signature of Reporting Person | Date | |
/s/ James C. Czirr, as Managing Member of 10X Capital Management, LLC | 11/05/2013 | |
**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) | 10X Fund, L.P. has direct beneficial ownership of all the securities owned by 10X Fund, L.P. 10X Capital Management, LLC, a Florida limited liability company, is the general partner of 10X Fund, L.P., a Delaware limited partnership, and may be deemed to have indirect beneficial ownership of all or a portion of the securities owned directly by 10X Fund, L.P. 10X Capital Management, LLC disclaims beneficial ownership of the reported securities except to the extent of its pecuniary interest therein. |
(2) | On May 13, 2009, 10X Fund, L.P. purchased (a) 450,000 shares of Series B-2 Preferred Stock, (b) one Class A-1 Warrant to purchase 150,000 shares of Common Stock for $3.00 per share, (c) one Class A-2 Warrant to purchase 150,000 shares of Common Stock for $3.00 per share, and (d) one Class B Warrant to purchase 600,000 shares of Common Stock for $3.00 per share, for aggregate consideration of $900,000. |
(3) | On June 30, 2009, 10X Fund, L.P. purchased (a) 250,000 shares of Series B-2 Preferred Stock, (b) one Class A-1 Warrant to purchase 833,333 shares of Common Stock for $3.00 per share, (c) one Class A-2 Warrant to purchase 83,333 shares of Common Stock for $3.00 per share, and (d) one Class B Warrant to purchase 333,333 shares of Common Stock for $3.00 per share, for aggregate consideration of $500,000. |