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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Common Stock Purchase Warrants (2) | $ 1.8 | 08/31/2004 | X | 850,620 | 07/28/1997(4) | 09/30/2007 | Common Stock | 850,620 | $ 0 | 0 | I | See Footnote (1) | |||
Series A-1 Preferred Stock (2) | (3) | 08/31/2004 | C | 40,800 | (5) | (5) | Common Stock | 226,666 | $ 0 | 0 | I | See Footnote (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
MIDDLEMAS GEROGE M 225 W. WASHINGTON SUITE 1500 CHICAGO, IL 60606 |
X |
/s/George M. Middlemas | 09/13/2004 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | These securities are directly owned by Apex Investment Fund II, L.P. ("Apex II"). The Reporting Person is a general partner of the sole general partner of Apex II. The Reporting Person disclaims beneficial ownership of all securities owned by Apex II except to the extent of his proportionate pecuniary interests therein. |
(2) | The warrants were exercised pursuant to a net exercise provision in the warrant agreement under which Pure Cycle withheld 188,795 shares in payment of the exercise price. |
(3) | The 40,800 shares of Series A-1 Preferred Shares were converted into 226,666 Common Shares. No additional consideration was paid on conversion. |
(4) | These securities were acquired at various times in 1991, 1996 and 1997. |
(5) | Immediately exercisable with no expiration date. |