Amended Statement of Beneficial Ownership (3/a)
16 September 2015 - 8:10PM
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...
0.5
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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
*
Denos Kenneth I
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2. Date of Event Requiring Statement (MM/DD/YYYY)
9/14/2015
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3. Issuer Name
and
Ticker or Trading Symbol
Fuelstream INC [FLST]
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(Last)
(First)
(Middle)
11650 SOUTH STATE STREET, SUITE 240
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4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
__
X
__ Director
_____ 10% Owner
___
X
___ Officer (give title below)
_____ Other (specify below)
CHIEF EXECUTIVE OFFICER /
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(Street)
DRAPER, UT 84020
(City)
(State)
(Zip)
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5. If Amendment, Date Original Filed
(MM/DD/YYYY)
9/16/2015
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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
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200
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D
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Common Stock
(1)
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475
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I
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see footnote
(1)
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Common Stock
(1)
(2)
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83809
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I
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see footnote
(1)
(2)
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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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Explanation of Responses:
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(
1)
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Held directly by Kenneth I. Denos, P.C., a Utah professional corporation owned and controlled by Mr. Denos
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(
2)
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Based on 1,693,085 shares of our common stock issued and outstanding as of September 16, 2015, and assuming the conversion of certain outstanding convertible debt held by the reporting person, into the maximum of 4.99% of the issued and outstanding shares of the Company as per the terms of the convertible debt.
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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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Denos Kenneth I
11650 SOUTH STATE STREET
SUITE 240
DRAPER, UT 84020
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X
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CHIEF EXECUTIVE OFFICER
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Signatures
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/s/ Kenneth Denos
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9/16/2015
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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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