UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 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. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series C Participating Convertible Preferred Stock | Â (3) | Â (3) | Common Stock | 74,649 (1) (3) | $ 0 (3) | D (2) | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
DMIC LLC C/O PRIVATE CAPITAL MANAGEMENT, INC. 2600 EAGAN WOODS DRIVE, SUITE 150 EAGAN, MN 55121 |
 |  X |  |  |
Peterson William C C/O DMIC LLC, C/O PRIVATE CAPITAL MANAGEMENT, INC. 2600 EAGAN WOODS DRIVE, SUITE 150, EAGAN, MN 55121 |
 |  X |  |  |
Smith Brian K C/O DMIC LLC, C/O PRIVATE CAPITAL MANAGEMENT, INC. 2600 EAGAN WOODS DRIVE, SUITE 150, EAGAN, MN 55121 |
 |  X |  |  |
/s/ Calvin Robertson | 08/01/2007 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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) | Does not reflect a 9 for 1 stock split, which the Issuer intends to effect through a dividend of 8 shares of its common stock for each share of its common stock outstanding immediately prior to the consummation of the Issuer's initial public offering. |
(2) | These shares are owned directly and solely by DMIC LLC. Brian K. Smith and William C. Peterson, as members of the board of governors of DMIC LLC, have shared investment and voting power with respect to, and therefore may be deemed the beneficial owners of, the securities owned by DMIC LLC. Each of Messrs. Smith and Peterson disclaim beneficial ownership of the securities of the Issuer owned by DMIC LLC except to the extent of their pecuniary interest therein, and this report shall not be deemed an admission that either Mr. Smith or Mr. Peterson is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. |
(3) | The series C participating convertible preferred stock is convertible into common stock at any time at the holder?s election on approximately a 1 to 14.84 basis, and has no expiration date. The Issuer has exercised its right to require the conversion of these shares. Therefore, each outstanding share of series C participating convertible preferred stock will convert into approximately 14.84 shares of common stock upon the consummation of the Issuer?s initial public offering. |