|
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, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
|
| |||||||||||||||||||||||||||||
|
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) |
||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Series A Convertible Stock | (1) | 03/15/2006 | D(2) | 9,422 | (3) | (4) | Common Stock | 628,133 | $ 0 | 0 | I | By One Clark, LLC (5) | |||
Series A Convertible Stock | (6) | 03/15/2006 | A(2) | 9,422 | (3) | (4) | Common Stock | 753,760 | $ 0 | 9,422 | I | By One Clark, LLC (5) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GOLDWASSER MARK C/O OLYMPIC CASCADE FINANCIAL CORP. 875 N. MICHIGAN AVENUE, SUITE 1560 CHICAGO, IL 60611 |
X | X | Chief Executive Officer |
Mark Goldwasser (By Michael A. Schwartz by Power of Attorney) | 03/17/2006 | |
**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) | The securities are convertible into shares of the Company's Common Stock at $1.50 per share. |
(2) | Amendment of the Company's Certificate of Designation reducing the conversion price of the Series A Convertible Preferred Stock resulting in deemed cancellation of outstanding shares and grant of replacement shares. |
(3) | The securities are exercisable immediately. |
(4) | Inapplicable. |
(5) | The reporting person is the manger and a member of the limited liability company that owns the securities. The reporting person disclaims beneficial ownership of the reported securities except to the extent of his pecuniary interest therein. |
(6) | The securities are convertible into shares of the Company's Common Stock at $1.25 per share. |