5: Statement of changes in beneficial ownership of securities
Published on April 26, 2005
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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) |
(e.g., puts, calls, warrants, options, convertible securities)
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 | |||||||||
Employee Stock Option (right to buy) | $ 1.27 | 03/02/2004 | A4 | 78,740 | 03/02/2005 | 03/02/2014 | Common Stock | $ 0 | 5,328,740 | |||||
Employee Stock Option (right to buy) | $ 0.98 | 03/02/2004 | A4 | 200,000 | 03/02/2005 | 03/02/2014 | Common Stock | $ 0 | 5,250,000 | |||||
Employee Stock Option (right to buy) | $ 0.98 | 03/02/2004 | A4 | 50,000 | 03/02/2005 | 03/02/2014 | Common Stock | $ 0 | 5,050,000 | |||||
Warrants to purchase common stock | $ 0.5 | 06/30/2003 | J4 | 2,000,000 | 06/30/2003 | 06/30/2008 | Common Stock | $ 0 | 5,000,000 | see footnote | ||||
Stock Options (right to buy) | $ 0.1 | 3 | (4) | 11/02/2011 | Common Stock | 3,000,000 |
Reporting Owners
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MASRY EDWARD L SAVE THE WORLD AIR, INC. 5125 LANKERSHIM BOULEVARD NORTH HOLLYWOOD, CA 91601 |
X | X | Chairman of the Board and CEO |
Signatures
/s/ EDWARD L. MASRY | 04/20/2005 | |
**Signature of Reporting Person | Date |
Explanation of Responses:
* | 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) | These 2,000,000 shares of Common Stock are held by Masry & Vititoe, PC, and Mr. Masry disclaims beneficial ownership of such shares except to the extent of his proportional share of that firm. Mr. Masry is a member of Masry & Vititoe, PC and may be deemed a beneficial owner of all such 2,000,000 shares of Common Stock held by the firm because of his status a member thereof. These shares, together with the warrants to purchase Common Stock referred to in Note(5) below, were issued in consideration of the cancellation of $500,000 of indebtedness of the Company to Masry & Vititoe, PC. |
(2) | These shares were issued to Joette Masry, the wife of Edward L. Masry in consideration of the cancellation of her $15,000 loan to the Company. |
(3) | These warrants are held by Masry & Vititoe, PC, and Mr. Masry disclaims beneficial ownership of such warrants except to the extent of his proportional share of that firm. Mr. Masry is a member of Masry & Vititoe, PC and may be deemed a beneficial owner of all such 2,000,000 shares held by that firm because of his status a member thereof. These warrants, together with the 2,000,000 shares of Common Stock referred to in Note (2) above, were issued in consideration of the cancellation of $500,000 indebtedness of the Company to Masry & Vititoe, PC. |
(4) | These options became exercisable in 3 equal annual installments commencing November 2, 2002. |