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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 | ||||||||
Bridge Note Warrants | $ 2 | 04/18/2005 | J(5) | 0 (5) | 04/18/2005 | 04/18/2008 | Common Stock | 14,491 | $ 2 | 14,491 | D | ||||
Bridge Note Warrants | $ 2 | 04/18/2005 | J(5) | 0 (5) | 04/18/2005 | 04/18/2008 | Common Stock | 43,816 | $ 2 | 43,816 | I | By Wife's IRA | |||
Unit Warrants | $ 2.5 | 04/18/2005 | J(5) | 0 (5) | 04/18/2005 | 04/18/2008 | Common Stock | 14,491 | $ 2.5 | 14,491 | D | ||||
Unit Warrants | $ 2.5 | 04/18/2005 | J(5) | 0 (5) | 04/18/2005 | 04/18/2008 | Common Stock | 43,816 | $ 2.5 | 43,816 | I | By Wife's IRA |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Streets Daniel W 22130 E. COSTILLA DRIVE AURORA, CO 80016 |
Former Officer |
Daniel W. Streets | 06/22/2005 | |
**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) | (1) On June 2, 2005, Dan and Carol Streets transferred 1,004,250 shares of common stock to Carol W. Streets. |
(2) | (2) On June 2, 2005, Dan and Carol Streets transferred 600,000 shares of common stock to a grantor retained annuity trust, "Daniel W. Streets 2005 Retained Annuity Trust." |
(3) | (3) On June 2, 2005, Dan and Carol Streets transferred 404,250 shares of common stock to Daniel W. Streets. |
(4) | 54,661 owned by Daniel W. and Carol H. Streets and joint tenants |
(5) | This transaction is a carryforward of derivative securities held. |
(6) | Transfer in ownership |