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4//SEC Filing

Crawford James T III 4

Accession 0001157523-09-006607

CIK 0001302177other

View on SEC.gov Company Profile

Filed

Sep 24, 8:00 PM ET

Accepted

Sep 25, 2:01 PM ET

Size

14.0 KB

Accession

0001157523-09-006607

Insider Transaction Report

Form 4

Period: 2009-08-20

POKERTEK, INC.PTEK

Crawford Ventures, LLC

10% Owner

Transactions

Gift
Common Stock
2009-09-15−36,000→ 1,196,610 total(indirect: By LLC)
Other
Common Stock
2009-08-20$0.72/sh+7,710$5,520→ 1,232,610 total(indirect: By LLC)
Other
Common Stock
2009-09-01$0.77/sh+7,151$5,521→ 7,151 total
Other
Common Stock
2009-09-10$0.83/sh+602,410$500,000→ 609,561 total
Award
Stock Options
2009-09-11+137,500→ 137,500 total
Exercise: $0.81From: 2010-03-11Exp: 2019-09-11→ Common (137,500 underlying)

Crawford James T III

DirectorPresident10% Owner

Transactions

Other
Common Stock
2009-08-20$0.72/sh+7,710$5,520→ 1,232,610 total(indirect: By LLC)
Other
Common Stock
2009-09-01$0.77/sh+7,151$5,521→ 7,151 total
Other
Common Stock
2009-09-10$0.83/sh+602,410$500,000→ 609,561 total
Gift
Common Stock
2009-09-15−36,000→ 1,196,610 total(indirect: By LLC)
Award
Stock Options
2009-09-11+137,500→ 137,500 total
Exercise: $0.81From: 2010-03-11Exp: 2019-09-11→ Common (137,500 underlying)

Footnotes (4)

[F1]Reporting Person elected to receive interest in the form of common stock at a 13% annual interest rate pursuant to a formula on $500,000 of indebtedness owed by PokerTek. The stock was valued at $0.716 per share under the formula.
[F2]Shares are owned of record by Crawford Ventures, LLC, for which voting and investment power is held by James T. Crawford, III. Mr. Crawford disclaims beneficial ownership of these shares except to the extent of his pecuniary interest therein.
[F3]Reporting Person elected to receive interest in the form of common stock at a 13% annual interest rate pursuant to a formula on $500,000 of indebtedness owed by PokerTek. The stock was valued at $0.772 per share under the formula.
[F4]Reporting Person converted $500,000 of indebtedness of PokerTek, Inc. into 602,410 shares of restricted common stock at a conversion price of $0.83 per share.

Documents

1 file

4
a6059054_ex.xmlPrimary

Issuer

POKERTEK, INC.

CIK 0001302177

Entity typeother

Related Parties

1

filerCIK 0001340708

Filing Metadata

Form type: 4
Filed: Sep 24, 8:00 PM ET
Accepted: Sep 25, 2:01 PM ET
Size: 14.0 KB

View on SEC.gov