- Annual Statement of Changes in Beneficial Ownership (5)
11 Febrero 2009 - 11:52AM
Edgar (US Regulatory)
FORM 5
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
[ ]
Form 3 Holdings Reported
[
X
]
Form 4 Transactions Reported
|
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
|
OMB APPROVAL
OMB Number:
3235-0362
Expires:
February 28, 2011
Estimated average burden
hours per response...
1.0
|
|
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(f) of the Investment Company Act of 1940
|
|
1. Name and Address of Reporting Person
*
IMPACT INTERNATIONAL L L C
|
2. Issuer Name
and
Ticker or Trading Symbol
TIDELANDS OIL & GAS CORP/WA [TIDE]
|
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director
__
X
__ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
|
(Last)
(First)
(Middle)
6305 WATERFORD BOULEVARD, SUITE 300
|
3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2008
|
(Street)
OKLAHOMA CITY, OK 73118
(City)
(State)
(Zip)
|
4. If Amendment, Date Original Filed
(MM/DD/YYYY)
|
6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form Filed by One Reporting Person
___ Form Filed by More than One Reporting Person
|
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
|
1.Title of Security
(Instr. 3)
|
2. Trans. Date
|
2A. Deemed Execution Date, if any
|
3. Trans. Code
(Instr. 8)
|
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
|
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
|
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
|
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
|
Amount
|
(A) or (D)
|
Price
|
Common Stock
|
3/25/2008
|
|
J4
(1)
|
39890180
|
A
|
(1)
|
48703160
|
D
|
|
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
|
1. Title of Derivate Security
(Instr. 3)
|
2. Conversion or Exercise Price of Derivative Security
|
3. Trans. Date
|
3A. Deemed Execution Date, if any
|
4. Trans. 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
(MM/DD/YYYY)
|
7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
|
8. Price of Derivative Security
(Instr. 5)
|
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year
(Instr. 4)
|
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
|
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
|
(A)
|
(D)
|
Date Exercisable
|
Expiration Date
|
Title
|
Amount or Number of Shares
|
Explanation of Responses:
|
(
1)
|
On March 25, 2008, the reporting person entered into a General Release (the "Release") with Tidelands Oil & Gas Corporation
("Tidelands"). Pursuant to the terms of the Release, the reporting person agreed to release Tidelands from all obligations
or liabilities under certain agreements between the reporting person and Tidelands, including (i) that certain promissory
note dated May 25, 2004 by Tidelands in favor of the reporting person in the original principal amount of $6,523,773
(the "Note"), (ii) certain related agreements entered into in connection with the Note, (iii) that certain Warrant Agreement
dated April 16, 2003, as amended, and (iv) that certain Registration Rights Agreement dated April 16, 2003, as amended.
As consideration for the Release, Tidelands (i) paid the reporting person $2,436,825, and (ii) issued 39,890,180 shares
of restricted Tidelands common stock to the reporting person.
|
Reporting Owners
|
Reporting Owner Name / Address
|
Relationships
|
Director
|
10% Owner
|
Officer
|
Other
|
IMPACT INTERNATIONAL L L C
6305 WATERFORD BOULEVARD
SUITE 300
OKLAHOMA CITY, OK 73118
|
|
X
|
|
|
Signatures
|
IMPACT INTERNATIONAL, LLC by JERRY WILLIAMS, Manager
|
|
2/10/2009
|
**
Signature of Reporting Person
|
Date
|
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
|
*
|
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).
|
Note:
|
File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
|
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.
|
Tidelands Oil and Gas (CE) (USOTC:TIDE)
Gráfica de Acción Histórica
De Nov 2024 a Dic 2024
Tidelands Oil and Gas (CE) (USOTC:TIDE)
Gráfica de Acción Histórica
De Dic 2023 a Dic 2024
Real-Time news about Tidelands Oil and Gas Corp (CE) (OTCMarkets): 0 recent articles
Más de Artículos de Noticias