UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Pertile Richard K 13575 58TH STREET NORTH - #138 CLEARWATER, FL 33760 |
 X |  X |  CEO, President | Chairman of the Board |
/s/ Richard K. Pertile by Steven L. Sample, PoA | 01/25/2016 | |
**Signature of Reporting Person | Date | |
Attorney-in-Fact for Reporting Person | 01/25/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Reporting Person was issued 960,000 new Common shares of Issuer under the terms of an Asset Purchase Agreement dated 01/15/2016. Reporting Person was also granted a proxy to vote 2,500,000 additional Common shares of Issuer held in trust under a Right of First Refusal to Purchase Common Shares granted to him by the outgoing CEO of Issuer, also under the terms of the referenced Asset Purchase Agreement. The details of those transactions are reported by the Issuer on an 8-K dated 01/18/2016 and incorporated herein by reference. |