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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT 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 2270 (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 at End of Issuer's Fiscal Year (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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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Common Stock Option | $ 1.67 | 10/01/2014 | 10/14/2014 | A4 (1) | 40,000 (2) | Â | Â (3) | 10/01/2020 | Common Stock Par Value $0.01 | (4) | 40,000 | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
FURNACE JUSTIN WAYNE 18428 MASI LOOP PFLUGERVILLE, TX 78660 |
 X |  |  |  |
Brittany Martin AIF for Justin Wayne Furnace | 01/28/2015 | |
**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 Form 5 is being filed to re-transmit a Form 4 filed on October 14, 2014, but was suspended on October 16, 2014 due to "Invalid Reporting File Number Block. The reporting file number for CIK 0001548197 does not have a valid prefix". |
(2) | On October 2, 2014, the Issuer grants the Reporting Person Non-Qualified Stock Options from the Issuer's 2011 Non-Employee Director's Stock Option Plan to purchase 40,000 shares of Common Stock at an exercise price of $1.67 per share. |
(3) | Options were fully vested and exercisable upon grant. |
(4) | Not applicable. |