Amended Statement of Beneficial Ownership (3/a)
01 Luglio 2016 - 11:58PM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
Estimated average burden
hours per response...
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
De Villiers Jean-Pierre
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2. Date of Event Requiring Statement (MM/DD/YYYY)
6/29/2012
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3. Issuer Name
and
Ticker or Trading Symbol
Leatt Corp [Leatt Corp]
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(Last)
(First)
(Middle)
GOEDEMOED FARM, KEISIE VALLEY
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
_____ Director
___
X
___ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Street)
MONTAGU, T3 6720
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
6/29/2012
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common stock, par value $0.001 per share
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5981580
(1)
(2)
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I
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By trust
(1)
(3)
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Common stock, par value $0.001 per share
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6226335
(1)
(2)
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D
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Series A Convertible Preferred Stock
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12/25/2008
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(4)
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common stock, par value $0.001 per share
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600000
(1)
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$0
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D
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Explanation of Responses:
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(
1)
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Does not give effect to a one-for-25 reverse stock split effected by the Issuer on September 12, 2012.
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(
2)
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This amendment is being filed to exclude shares held by members of Mr. De Villiers' family which are not beneficially owned by the reporting person and in which the reporting person has no direct or indirect pecuniary interest. Such shares were incorrectly included in the reporting person's holdings on the original Form 3. Additionally, this amendment is being filed to include certain shares that are directly held by Mr. De Villiers, which were incorrectly excluded in the reporting person's holdings on the original Form 3.
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(
3)
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Represents shares held by Mr. De Villiers though the Jean Pierre de Villiers Trust.
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(
4)
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The shares of Series A Convertible Preferred stock are convertible into the Issuer's common stock on the basis of a one common share for each preferred share held.
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Remarks:
See attachment for Exhibit 24 - Limited Power of Attorney for Section 16 Reporting Obligations.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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De Villiers Jean-Pierre
GOEDEMOED FARM
KEISIE VALLEY
MONTAGU, T3 6720
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X
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Signatures
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/s/ Avryl Blum, Attorney-in-fact for Jean Pierre De Villiers
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7/1/2016
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 5(b)(v).
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**
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Intentional misstatements or omissions of facts constitute Federal Criminal Violations.
See
18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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.
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