|5Apr 27, 3:41 PM ET

van Houweninge Mathijs 5

5 · Blackwater Midstream Corp. · Filed Apr 27, 2012

Insider Transaction Report

Form 5
Period: 2011-12-21
Transactions
  • Exercise/Conversion

    Common Stock

    2011-12-21$0.42/sh+420,168$176,4711,561,654 total
  • Tax Payment

    Stock Options (Right to Buy)

    2011-12-21$0.17/sh285,714$48,5710 total
    Exercise: $0.17From: 2011-12-21Exp: 2012-01-01Common Shares (705,882 underlying)
  • Exercise/Conversion

    Stock Options (Right to Buy)

    2011-12-21$0.17/sh420,168$71,4290 total
    Exercise: $0.17From: 2011-12-21Exp: 2012-01-01Common Shares (705,882 underlying)
Footnotes (2)
  • [F1]Pursuant to a stock option grant in April 2009, in consideration for services rendered as a member of the issuer's Board of Directors, on December 21, 2011 reporting person exercised 705,882 options at $0.17 per share = $120,000; in an authorized cashless transaction. The cashless transaction resulted in the surrender of 285,714 common shares based on the closing per share price of $0.42 as of December 21, 2011 = $120,000, and the resulting issuance of 420,168 common shares.
  • [F2]Pursuant to a stock option grant in April 2009, in consideration for services rendered as a member of the issuer's Board of Directors, on December 21, 2011 reporting person exercised 705,882 options at $0.17 per share = $120,000; in an authorized cashless transaction. The cashless transaction resulted in the surrender of 285,714 common shares based on the closing per share price of $0.42 as of December 21, 2011 = $120,000, and the resulting issuance of 420,168 common shares.

Documents

1 file
  • 5
    rdgdoc.xmlPrimary

    HOUWENINGE - FORM 5