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 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Coast Medina, LLC 2450 COLORADO AVE., SUITE 100 E. TOWER SANTA MONICA, CA 90404 |
 |  X |  |  |
Coast Fund, LP 2450 COLORADO AVE. SUITE 100 E. TOWER SANTA MONICA, CA 90404 |
 |  X |  |  |
By: The Coast Fund, L.P., By: Coast Offshore Management (Cayman), Ltd., its managing general partner, By: /s/ David E. Smith, President | 04/09/2012 | |
**Signature of Reporting Person | Date | |
By: Coast Medina, LLC, By: Coast Offshore Management (Cayman), Ltd., its managing general partner, By: /s/ David E. Smith, President | 04/09/2012 | |
**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) | Pursuant to a Contribution Agreement entered into by David E. Smith and The Coast Fund, L.P. on March 30, 2012 (the "Contribution Agreement"), Mr. Smith's Common Stock holdings of the Issuer were contributed to The Coast Fund, L.P., which concurrently contributed such Common Stock to Coast Medina, LLC, a wholly owned subsidiary of The Coast Fund, L.P. The Coast Fund, L.P. is the sole member of Coast Medina, LLC, and Coast Offshore Management (Cayman), Ltd. serves as the managing general partner of the Coast Fund, L.P. Mr. Smith is the President of Coast Offshore Management (Cayman), Ltd. Under the Contribution Agreement, Mr. Smith retains his entire pecuniary interest in the Common Stock, including 100% of the profits, losses, burdens, benefits and risks associated with the contributed Common Stock. |
 Remarks: Each of the Coast Fund, L.P., Coast Medina, LLC and Coast Offshore Management (Cayman), Ltd. disclaims beneficial ownership of the securities included in this Form 3 and in all other reports filed by him or it under Section 16 of the Securities Exchange Act of 1934, as amended, with respect to the Issuer, except to the extent of its pecuniary interest therein. |