4//SEC Filing
JOSIPOVICH DANIEL T 4
Accession 0001144204-04-016873
CIK 0001126577other
Filed
Oct 25, 8:00 PM ET
Accepted
Oct 26, 12:50 PM ET
Size
11.2 KB
Accession
0001144204-04-016873
Insider Transaction Report
Form 4
JOSIPOVICH DANIEL T
DirectorChief Operating Officer10% Owner
Transactions
- Conversion
Series B Convertible Preferred Stock
2004-10-14−1,014.75→ 0 total(indirect: See footnote)From: 2001-11-14→ Common Stock - Other
Common Stock
2004-10-14+9,549,685→ 15,224,685 total - Conversion
Common Stock
2004-10-14+27,060,000→ 27,060,000 total(indirect: See footnote)
Footnotes (6)
- [F1]Pursuant to a debt settlement agreement between the Company and Daniel T. Josipovich, the Company has agreed to convert $358,113.19 of debt owed by it to Daniel T. Josipovich into 9,549,685 shares of Common Stock.
- [F2]Daniel T. Josipovich is the trustee of a trust holding membership units of The Freedom Family, LLC. The LLC holds 2,050 shares of Series B Convertible Preferred Stock which it elected to convert into 54,666,667 shares of Common Stock based on a conversion price of $0.0375 per share as of 10/14/04. The number in column 5 represents the trust's proportionate interest in the Common Stock owned by the LLC. The managers of the LLC exercise sole discretion over the Common Stock owned by the LLC, including whether any distributions, if any, are made by the LLC to holders of the membership interests.
- [F3]Conversion price of $0.0375 per share as of 10/14/04. These shares of Common Stock will be issued upon conversion of the Series B Preferred Stock held by the LLC, and upon conversion, will be owned by the LLC. Under SEC rules and regulations, these shares may be deemed to be beneficially owned by Daniel T. Josipovich because the trust of which he is a trustee holds membership units of the LLC and may thus be deemed to have a direct or indirect pecuniary interest in such shares. The managers of the LLC, and not the trust of which Daniel T. Josipovich is a trustee, exercise sole discretion over these shares, including whether to distribute the shares to the trust of which Daniel T. Josipovich is a trustee.
- [F4]27,060,000 shares of Common Stock based on conversion price as of 10/14/04.
- [F5]Daniel T. Josipovich is the trustee of a trust to which membership units of The Freedom Family, LLC were transferred as a gift. The LLC owns the derivative securities and elected to convert them into shares of Common Stock as of 10/14/04. The number in column 7 represented the trust's proportionate interest in the derivative securities.
- [F6]None.
Documents
Issuer
BLUEBOOK INTERNATIONAL HOLDING CO
CIK 0001126577
Entity typeother
Related Parties
1- filerCIK 0001160666
Filing Metadata
- Form type
- 4
- Filed
- Oct 25, 8:00 PM ET
- Accepted
- Oct 26, 12:50 PM ET
- Size
- 11.2 KB