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 | ||||
Warrant | 12/08/2015 | 06/08/2020 | Common Shares | 5,967,000 | $ 0.95 | I | By trust (2) |
Warrant | 12/08/2015 | 06/08/2020 | Common Shares | 1,533,000 | $ 0.95 | I | By trust (3) |
Warrant | 11/21/2016 | 11/21/2021 | Common Shares | 4,773,600 | $ 0.85 | I | By trust (4) |
Warrant | 11/21/2016 | 11/21/2021 | Common Shares | 1,226,400 | $ 0.85 | I | By trust (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Clay Richard T C/O EAST HILL MANAGEMENT COMPANY, LLC 70 MAIN STREET, SUITE 300 PETERBOROUGH, NH 03458 |
 |  X |  |  |
/s/ Richard T. Clay | 11/30/2016 | |
**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) | Represents shares owned by Arctic Coast Petroleums, Ltd. ("Arctic Coast"). The reporting person is a trustee of the Clay Family 2009 Irrevocable Trust dated April 14, 2009 (the "CF 2009 Trust"), which owns 50% of Arctic Coast. The reporting person's father is the donor of the portion of Arctic Coast held by the CF 2009 Trust. |
(2) | On June 8, 2015 the issuer issued a warrant to purchase 5,967,000 shares of common stock to the Landon T. Clay 2009 Irrevocable Trust dated March 6, 2009 (the "LTC 2009 Trust"), of which the reporting person is a trustee. The warrant is currently exercisable and expires on June 8, 2020. |
(3) | On June 8, 2015 the issuer issued a warrant to purchase 1,533,000 shares of common stock to the CF 2009 Trust, of which the reporting person is a trustee. The warrant is currently exercisable and expires on June 8, 2020. |
(4) | On November 21, 2016 the issuer issued a warrant to purchase 4,773,600 shares of common stock to the LTC 2009 Trust, of which the reporting person is a trustee. The warrant is currently exercisable and expires on November 21, 2021. |
(5) | On November 21, 2016 the issuer issued a warrant to purchase 1,226,400 shares of common stock to the CF 2009 Trust, of which the reporting person is a trustee. The warrant is currently exercisable and expires on November 21, 2021. |