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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 | |
TULLO ANGELO C/O SUNBELT FINANCIAL CONCEPTS, INC. 4710 N. FALCON DRIVE, SUITE 202 MESA, AZ 85205 |
Former President & CEO |
/s/ Angelo Tullo, President | 10/07/2004 | |
**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) | The shares were awarded by Sunbelt Financial Concepts, Inc. ("Sunbelt"), of which the Reporting Person is President, as a bonus to an officer of Sunbelt. |
(2) | Includes 3,866,580 shares owned by Sunbelt, of which the Reporting Person is President. The Reporting Person has dispositive power over the shares owned by Sunbelt but has no ownership interest in Sunbelt. The Reporting Person disclaims beneficial ownership of the shares owned by Sunbelt except to the extent of any proportionate interest therein. |
(3) | Sunbelt, in a private transaction with DeVal Johnson, a director of the Issuer, exchanged 250,000 shares of the Issuer for shares in another private company that Mr. Johnson's Family Trust has an interest in. |
(4) | Includes 3,616,580 shares owned by Sunbelt, of which the Reporting Person is President. The Reporting Person has dispositive power over the shares owned by Sunbelt but has no ownership interest in Sunbelt. The Reporting Person disclaims beneficial ownership of the shares owned by Sunbelt except to the extent of any proportionate interest therein. |