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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 | |
Sample Steven L 3512 E. SILVER SPRINGS BLVD - #243 OCALA, FL 34470 |
X | X | CEO, President, Chairman |
/s/ Steven L. Sample | 08/27/2012 | |
**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) | This report is a correction of the Form 4 filed by Reporting Person on 6/26/2012, in which the Reporting Person accidentally misstated the Amount of Securities Beneficially Owned Following Reported Transactions on that date in Table 1 (5). Reporting Person inadvertently failed to include 20,614 shares he had previously acquired in the open marketplace and which he properly reported on previous Forms 4. The error does not constitute a material event. The Form 4 of this date properly sets forth the total number of shares held by the Reporting Person, both as a registered shareholder and as a direct beneficial shareholder. Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any person in his securities. |
Remarks: This report is a correction of the Form 4 filed by Reporting Person on 6/26/2012, in which the Reporting Person accidentally misstated the Amount of Securities Beneficially Owned Following Reported Transactions on that date in Table 1 (5). Reporting Person inadvertently failed to include 20,614 shares he had previously acquired in the open marketplace and which he properly reported on previous Forms 4. The error does not constitute a material event. The Form 4 of this date properly sets forth the total number of shares held by the Reporting Person, both as a registered shareholder and as a direct beneficial shareholder. Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any person in his securities. |