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 | ||||
Warrant | Â (2) | Â (3) | Common Stock | 503,375 | $ 7.5 | I | By Hendricks Family LLLP (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
HENDRICKS MAUREEN A 217 RUDDER ROAD VERO BEACH, FL 32963 |
 X |  |  |  |
/s/ Maureen A. Hendricks | 01/29/2007 | |
**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) | Hendricks Family LLLP, a Florida limited liability limited partnership jointly controlled by Ms. Hendricks and her husband, owns 67.5% of such securities. Ms. Hendricks, as the Trustee of the "Maureen A. Hendricks Revocable Trust u/a July 9, 2003", owns 32.5% of such securities. Although Ms. Hendricks may be viewed as having beneficial ownership of all of such securities, Ms. Hendricks disclaims beneficial ownership of any securities in which she does not have a pecuniary interest. |
(2) | On the later of: (i) the completion of the initial business combination by the issuer; or (ii) 13 months after the closing of the public offering. |
(3) | On the earlier of: (i) 4 years after the date of the prospectus; or (ii) the date of redemption or liquidation of the trust account. |