|5Jan 28, 5:17 PM ET

Unruh Ray L 5

5 · Mesa Energy Holdings, Inc. · Filed Jan 28, 2013

Insider Transaction Report

Form 5
Period: 2012-12-31
Unruh Ray L
DirectorPresident, Sec. and CFO10% Owner
Transactions
  • Other

    Option to Sell Outstanding Common Stock (right to sell)

    2012-12-17$10.00/sh3,667,461$36,674,6100 total
    Exercise: $0.10Common Stock (3,667,461 underlying)
  • Gift

    Common Stock

    2012-12-171,900,0001,875,000 total
  • Other

    Common Stock

    2012-12-172,249,7220 total(indirect: By Cherokee Financial Corp.)
  • Other

    Common Stock

    2012-12-17+2,763,4245,395,963 total(indirect: By Unruh & Unruh Properties Ltd.)
  • Other

    Option to Sell Outstanding Common Stock (right to sell)

    2012-12-17$10.00/sh1,332,539$13,325,3900 total(indirect: Option sold by Unruh & Unruh Properties, Ltd.)
    Exercise: $0.10Common Stock (1,332,539 underlying)
  • Sale

    Option to Sell Outstanding Common Stock (right to sell)

    2012-12-17$10.00/sh1,800,000$18,000,0001,800,000 total
    Exercise: $0.10From: 2012-12-17Exp: 2015-06-01Common Stock (1,800,000 underlying)
Holdings
  • Common Stock

    (indirect: By Ray L. Unruh Profit Sahring Plan)
    770,830
Footnotes (6)
  • [F1]On December 17, 2012, Mr. Unruh gifted 1,900,000 shares of the common stock of the Issuer, which he directly owned. On that date he also transferred 513,702 shares to Unruh & Unruh Properties Ltd. of which Mr. Unruh is the president and general partner.
  • [F2]Includes 75,000 shares under a restricted stock grant pursuant to the Issuer's 2009 Equity Incentive Plan, of which 30,000 shares will vest on March 30, 2013 and 45,000 shares, on September 30, 2013.
  • [F3]Ray L. Unruh transferred 2,249,722 shares of the common stock of the Issuer from Cherokee Financial Corp., of which Mr. Unruh is the sole officer, director and shareholder, to Unruh & Unruh Properties Ltd.
  • [F4]Cancellation for value of fully vested option to sell outstanding common stock of the Issuer sold to Randy Griffin, Chief Executive Officer of the Issuer, pursuant to agreement between the parties dated December 17, 2012.
  • [F5]Option (fully vested) to sell outstanding common stock of the Issuer sold to Randy Griffin, Chief Executive Officer of the Issuer. Pursuant to the agreement between the parties dated December 12, 2012, this option supersedes and cancels the previous option agreement between the parties dated June 10, 2010 pursuant to which Mr. Unruh sold to Mr. Griffin an option to purchase 3,667,461 shares of outstanding common stock of the Issuer.
  • [F6]Cancellation for value of fully vested option to sell outstanding common stock of the Issuer sold to Randy Griffin, Chief Executive Officer of the Issuer, pursuant to agreement between the parties dated December 12, 2012.

Documents

1 file
  • 5
    doc1.xmlPrimary

    FORM 5