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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 | ||||||||
Warrant | $ 0.2 | 12/29/2016 | P | 400,000 | 12/29/2016 | 01/31/2020 | Common stock | 400,000 | $ 0.2 | 2,450,000 | D | ||||
Director's Stock Options (Right to Buy) (3) | $ 0.15 | 12/30/2016 | A | 125,000 | 12/30/2016 | 12/30/2019 | Common stock | 125,000 | $ 0 | 2,575,000 | D | ||||
Director's Stock Option (Right to buy) (3) | $ 0.15 | 12/30/2016 | A | 125,000 | 12/29/2017 | 12/30/2019 | Common stock | 125,000 | $ 0 | 2,700,000 | D | ||||
Director's Stock Option (Right to buy) | $ 0.1 | 12/30/2016 | X | 250,000 | 04/30/2014 | 04/30/2017 | Common stock | 250,000 | $ 0.1 | 2,450,000 | D | ||||
Director's Stock Option (Right to buy) | $ 0.1 | 12/30/2016 | X | 250,000 | 04/30/2015 | 04/30/2018 | Common stock | 250,000 | $ 0.1 | 2,200,000 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Swallow John 201 N THIRD STREET COEUR D'ALENE, ID 83814 |
X | X | President |
/s/ John Swallow | 01/03/2017 | |
**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) | Common Stock and Warrants purchased on 12/29/2016 were sold together as Units in the Issuer's private placement at a sale price of $.20 per Unit. Each Unit consisted of two (2) shares of Common Stock and one (1) Warrant to purchase one (1) share of Common Stock at $.20 per share for a period of 36 months. The average price per share was $.10. |
(2) | Common Stock purchased on 12/30/2016 was an exercise of Director's Stock Options. |
(3) | The Director's options granted on 12/30/16 vest as follows: 125,000 on 12/30/2016, and 125,000 on 12/29/2017. |