THIRD MELLENNIUM INDUSTRIES INC 3

3 · THIRD MELLENNIUM INDUSTRIES INC · Filed Feb 11, 2004

Form 3

Period: 2003-12-30

10% Owner

Holdings

Common Stock, Par Value $0.001
140,000
18% Convertible Promissory Note
Exercise: $0.75From: 2003-08-01Exp: 2004-01-27→ Common Stock, Par Value $0.001
Common Stock, Par Value $0.001
(indirect: See Footnote)
1,890,000
Common Stock, Par Value $0.001
(indirect: See Footnote)
5,332,713
Warrant
(indirect: By LLC)
Exercise: $1.25From: 2003-12-30Exp: 2007-05-30→ Common Stock, Par Value $0.001 (3,000,000 underlying)
Convertible Preferred Stock
(indirect: See Footnote)
Exercise: $0.00From: 2004-05-30→ Common Stock, Par Value $0.001 (12,000,000 underlying)

Footnotes (4)

[F1]As owner of 70% interest in Barrett Sutherland Acquisition, LLC, which beneficially owns these shares under a contractual right for Issuer to cause transfer from record shareholders
[F2]As owner of 70% interest in Barrett Sutherland Acquisition, LLC, which beneficially owns these shares under a contractual right for Issuer to cause transfer of 99% ownership of entity with record ownership of these shares
[F3]As owner of 70% interest in Barrett Sutherland Acquisition, LLC which beneficially owns these shares under a contractual right for Issuer to issue these shares
[F4]There is no expiration date associated with the conversion of Convertible Preferred Stock into Common Stock.

Documents

1 file