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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 to Purchase Common Stock | $ 0.01 | 03/08/2011 | X | 9,371,243 | (2) | 02/22/2017 | Common Stock | 9,371,243 | $ 0 | 7,275,930 (3) | D (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Vintage Capital Group, LLC 11611 SAN VICENTE BLVD., 10TH FLOOR LOS ANGELES, CA 90049 |
X | |||
Fred C. Sands Children's Trust 11611 SAN VICENTE BLVD., 10TH FLOOR LOS ANGELES, CA 90049 |
X | |||
Fred C. Sands Family Revocable Trust 11611 SAN VICENTE BLVD., 10TH FLOOR LOS ANGELES, CA 90049 |
X | |||
Sands Fred C 11611 SAN VICENTE BLVD., 10TH FLOOR LOS ANGELES, CA 90049 |
X |
/s/ Fred C. Sands, Manager | 03/08/2011 | |
**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 Fred C. Sands Children's Trust (the "Children's Trust") owns 15% of the membership interests of Vintage Capital Group, LLC ("Vintage"). Fred C. Sands ("Mr. Sands") is the trustee of the Children's Trust. The Fred C. Sands Family Revocable Trust (the "Family Trust") owns 85% of the membership interests of Vintage. Mr. Sands is the trustee of the Family Trust. Each of Mr. Sands, the Children's Trust and the Family Trust may be deemed to share beneficial ownership of the shares beneficially owned by Vintage. |
(2) | Immediately exercisable at the discretion of the holder. |
(3) | Following the partial exercise of the Warrant described herein, the Warrant is exercisable into 7,275,930 shares as of the date hereof. As the Warrant is exercisable into a percentage of the Issuer's Common Stock, the number of shares into which the Warrant is exercisable is variable. |
Remarks: Exhibit 99 - Joint Filer Information |