SECURITIES AND EXCHANGE COMMISSION
Washington, DC 20549
SCHEDULE 13G
(Rule 13d-102)
INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT
TO RULES 13d-1(b), (c), AND (d) AND AMENDMENTS THERETO FILED
PURSUANT TO RULE 13d-2
(Amendment No._________)*
Poker Magic, Inc.
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(Name of Issuer)
Common Stock
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(Title of Class of Securities)
73086A 10 1
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(CUSIP Number)
December 31, 2009
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(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this
Schedule is filed:
|_| Rule 13d-1(b)
|X| Rule 13d-1(c)
|_| Rule 13d-1(d)
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* The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which
would alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities Exchange
Act of 1934 or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
CUSIP No. 73086A 10 1 13G Page 2 of 5 Pages
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1. NAME OF REPORTING PERSONS
Gary Kostiuk
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2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP*
(a) |_|
(b) |_|
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3. SEC USE ONLY
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4. CITIZENSHIP OR PLACE OF ORGANIZATION
USA
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NUMBER OF 5. SOLE VOTING POWER
SHARES 541,000
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BENEFICIALLY 6. SHARED VOTING POWER
OWNED BY 0
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EACH 7. SOLE DISPOSITIVE POWER
REPORTING 541,000
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PERSON 8. SHARED DISPOSITIVE POWER
WITH 0
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9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON
541,000 SHARES
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10. CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE
INSTRUCTIONS) |_|
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11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9)
5.5%
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12. TYPE OF REPORTING PERSON*
IN
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CUSIP No. 73086A 10 1 13G Page 3 of 5 Pages
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Item 1(a). Name of Issuer:
Poker Magic, Inc.
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Item 1(b). Address of Issuer's Principal Executive Offices:
130 Lake Street West, Suite 300, Wayzata, MN 55391
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Item 2(a). Name of Person Filing:
Gary Kostiuk
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Item 2(b). Address of Principal Business Office, or if none, Residence:
257 Frog Pond Road, Parkertown, NJ 08087
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Item 2(c). Citizenship:
Mr. Kostiuk is a citizen of the United States.
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Item 2(d). Title of Class of Securities:
Common Stock
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Item 2(e). CUSIP Number:
73086A 10 1
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Item 3. If This Statement is Filed Pursuant to ss.ss. 240.13d-1(b), or
240.13d-2(b) or (c), check whether the person filing is a:
(a) |_| Broker or dealer registered under Section 15 of the Act (15
U.S.C. 78o);
(b) |_| Bank as defined in Section 3(a)(6) of the Act (15 U.S.C. 78c);
(c) |_| Insurance company as defined in Section 3(a)(19) of the Act (15
U.S.C. 78c);
(d) |_| Investment company registered under Section 8 of the Investment
Company Act of 1940 (15 U.S.C. 80a-8);
(e) |_| An investment adviser in accordance with ss.
240.13d-1(b)(1)(ii)(E);
(f) |_| An employee benefit plan or endowment fund in accordance with
ss. 240.13d-1(b)(1)(ii)(F);
(g) |_| A parent holding company or control person in accordance with
ss. 240.13d-1(b)(1)(ii)(G);
(h) |_| A savings association as defined in Section 3(b) of the Federal
Deposit Insurance Act (12 U.S.C. 1813);
(i) |_| A church plan that is excluded from the definition of an
investment company under Section 3(c)(14) of the Investment Company
Act (15 U.S.C. 80a-3);
(j) |_| A non-U.S. institution in accordance with ss.
240.13d-1(b)(1)(ii)(J);
(k) |_| Group, in accordance with ss. 240.13d-1(b)(1)(ii)(K).
If filing as a non-U.S. institution in accordance with ss.
240.13d-1(b)(1)(ii)(J), please specify the type of institution:
__________________.
CUSIP No. 73086A 10 1 13G Page 4 of 5 Pages
Item 4. Ownership.
Provide the following information regarding the aggregate number and
percentage of the class of securities of the issuer identified in Item 1.
(a) Amount beneficially owned:
541,000 SHARES
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(b) Percent of class:
5.5%
(Based upon 9,763,224 shares outstanding on November 2, 2009 as
reported by the Issuer in its most recently filed Form 10Q)
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(c) Number of shares as to which such person has:
(i) Sole power to vote or to direct the vote: 541,000
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(ii) Shared power to vote or to direct the vote: 0
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(iii) Sole power to dispose or to direct the disposition of: 541,000
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(iv) Shared power to dispose or to direct the disposition of: 0
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Item 5. Ownership of Five Percent or Less of a Class.
N/A
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Item 6. Ownership of More Than Five Percent on Behalf of Another Person.
N/A
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Item 7. Identification and Classification of the Subsidiary Which Acquired the
Security Being Reported on by the Parent Holding Company or Control Person.
N/A
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Item 8. Identification and Classification of Members of the Group.
N/A
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Item 9. Notice of Dissolution of Group.
N/A
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Item 10. Certifications.
(a) Not applicable
(b) Not applicable
(c) By signing below I certify that, to the best of my knowledge and
belief, the securities referred to above were not acquired and are not held for
the purpose of or with the effect of changing or influencing the control of the
issuer of the securities and were not acquired and are not held in connection
with or as a participant in any transaction having that purpose or effect.
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Dated: February 26, 2010 /s/ Gary Kostiuk
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Gary Kostiuk