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 | |
Puishys Joseph F. 4400 WEST 78TH STREET SUITE 520 MINNEAPOLIS, MN 55435 |
 X |  |  Chief Executive Officer & Pres |  |
/s/ Patricia A. Beithon, Attorney-in-Fact for Joseph F. Puishys | 08/08/2011 | |
**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) | On August 2, the Board of Directors of the Issuer elected the Reporting Person as the Issuer's Chief Executive Officer, effective as of August 22, 2011 (the "Commencement Date"). On August 5, 2011, the Reporting Person and the Issuer entered into an Employment Agreement (the "Employment Agreement") to be effective as of the Commencement Date. Pursuant to the Employment Agreement, the Reporting Person will be granted on the Commencement Date unrestricted shares of the Issuer's common stock valued at $500,000, shares of time-based restricted stock of the Issuer valued at $1,300,000 and options to purchase shares of the Issuer's stock valued (using a Black-Scholes valuation) at $1,300,000. The number of shares and options to be granted and the option exercise price will be determined on the Commencement Date. In addition, on August 2, 2011, the Board of Directors of the Issuer elected the Reporting Person to the Issuer's Board, effective as of August 22, 2011. |