-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, I7v9DY/l2B5hA79bhBW3hjCUxdzMHv79+k6np1JVvw74VjUiYMC4W7QnX1n9IC0h b6nYZrFW9Q2gTTBLmazHdg== 0001029737-97-000057.txt : 19970222 0001029737-97-000057.hdr.sgml : 19970222 ACCESSION NUMBER: 0001029737-97-000057 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19970213 SROS: NONE GROUP MEMBERS: HEAD DONALD R GROUP MEMBERS: THE HEAD REVOCABLE TRUST DATED APRIL 1, 1975 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CAPITAL TITLE GROUP INC CENTRAL INDEX KEY: 0001017158 STANDARD INDUSTRIAL CLASSIFICATION: REAL ESTATE DEALERS (FOR THEIR OWN ACCOUNT) [6532] IRS NUMBER: 870399785 STATE OF INCORPORATION: DE FISCAL YEAR END: 1031 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-49613 FILM NUMBER: 97530867 BUSINESS ADDRESS: STREET 1: 138 N MONTEZUMA CITY: PRESCOTT STATE: AZ ZIP: 86301 BUSINESS PHONE: 5207789194 MAIL ADDRESS: STREET 1: 4808 N 22ND ST CITY: PHOENIX STATE: AZ ZIP: 85016 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HEAD DONALD R CENTRAL INDEX KEY: 0001031886 STANDARD INDUSTRIAL CLASSIFICATION: [] IRS NUMBER: 000000000 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 4808 NORTH 22ND STREET STREET 2: CAPITAL TITLE GROUP INC CITY: PHOENIX STATE: AZ ZIP: 85016 BUSINESS PHONE: 6029540022 MAIL ADDRESS: STREET 1: C/O CAPITAL TITLE GROUP INC STREET 2: 4808 NORTH 22ND STREET CITY: PHOENIX STATE: AZ ZIP: 85016 SC 13G 1 SCH. 13G OF DONALS HEAD & THE HEAD TRUST UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. )* CAPITAL TITLE GROUP, INC. ------------------------- (Name of Issuer) Common Stock, $.001 par value ----------------------------- (Title of Class of Securities) 140919 10 1 ----------- (CUSIP Number) *The remainder of this cover page shall be filled out for a reporting person's initial filing on this form with respect to the subject class of securities, and for any subsequent amendment containing information which would alter the disclosures provided in a prior cover page. The information required in the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Securities Exchange Act of 1934 ("Act") or otherwise subject to the liabilities of that section of the Act but shall be subject to all other provisions of the Act (however, see the Notes). SCHEDULE 13G - --------------------- ----------------- CUSIP NO. 140919 10 1 PAGE 2 OF 8 PAGES - --------------------- ----------------- 1 NAMES OF REPORTING PERSONS S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS DONALD R. HEAD - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) / / N/A (b) / / - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 2,627,345 NUMBER OF ------------------------------------------------------------------ SHARES 6 SHARED VOTING POWER BENEFICIALLY 0 OWNED BY ------------------------------------------------------------------ EACH 7 SOLE DISPOSITIVE POWER REPORTING 2,627,345 PERSON ------------------------------------------------------------------ WITH 8 SHARED DISPOSITIVE POWER 0 - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 2,627,345 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* / / N/A - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 26% based upon 10,316,029 shares outstanding at 12/31/96. - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! SCHEDULE 13G - --------------------- ----------------- CUSIP NO. 140919 10 1 PAGE 3 OF 8 PAGES - --------------------- ----------------- 1 NAMES OF REPORTING PERSONS S.S. OR I.R.S. IDENTIFICATION NOS. OF ABOVE PERSONS THE HEAD REVOCABLE TRUST DATED APRIL 1, 1975 - -------------------------------------------------------------------------------- 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) / / N/A (b) / / - -------------------------------------------------------------------------------- 3 SEC USE ONLY - -------------------------------------------------------------------------------- 4 CITIZENSHIP OR PLACE OF ORGANIZATION State of Arizona - -------------------------------------------------------------------------------- 5 SOLE VOTING POWER 2,025,205 NUMBER OF ------------------------------------------------------------------ SHARES 6 SHARED VOTING POWER BENEFICIALLY 0 OWNED BY ------------------------------------------------------------------ EACH 7 SOLE DISPOSITIVE POWER REPORTING 2,025,205 PERSON ------------------------------------------------------------------ WITH 8 SHARED DISPOSITIVE POWER 0 - -------------------------------------------------------------------------------- 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 2,025,205 - -------------------------------------------------------------------------------- 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* / / N/A - -------------------------------------------------------------------------------- 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 20%, based upon 10,316,029 shares outstanding at 12/31/96. - -------------------------------------------------------------------------------- 12 TYPE OF REPORTING PERSON* 00 - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! ITEM 1(A) NAME OF ISSUER: Capital Title Group, Inc. ITEM 1(B) ADDRESS OF ISSUER'S PRINCIPAL EXECUTIVE OFFICES: 4808 North 22nd Street Phoenix, Arizona 85016 ITEM 2(A) NAME OF PERSON FILING: The persons filing this Schedule 13G are: * (1) Donald R. Head (2) The Head Revocable Trust Dated April 1, 1975 --------- * Attached to this Schedule 13G as Exhibit 1 is a Joint Filing Agreement between the persons specified above that this Schedule 13G is being filed on behalf of each of them. ITEM 2(B) ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE: The principal business address of the persons filing this Schedule 13G is 4808 North 22nd Street, Phoenix, Arizona 85016 ITEM 2(C) CITIZENSHIP: Donald R. Head is a citizen of the United States. The Head Revocable Trust was formed under the laws of the State of Arizona. ITEM 2(D) TITLE OF CLASS OF SECURITIES: Common Stock, $.001 par value ITEM 2(E) CUSIP NUMBER: 140919 10 1 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO RULES 13D-1(B)OR 13D-2(B), CHECK WHETHER THE PERSON FILING IS A: (a) / / Broker or Dealer registered under Section 15 of the Act (b) / / Bank as defined in Section 3(a)(6) of the Act (c) / / Insurance Company as defined in Section 3(a)(19) of the Act (d) / / Investment Company registered under Section 8 of the Investment Company Act (e) / / Investment Adviser registered under Section 203 of the Investment Advisers Act of 1940 Page 4 of 8 Pages (f) / / Employee Benefit Plan, Pension Fund which is subject to the provisions of the Employee Retirement Income Security Act of 1974 or Endowment Fund; see ss.240.13d-1(b)(1)(ii)(F) (g) / / Parent Holding Company, in accordance with ss.240.13d-1(b)(1) (ii)(G) (NOTE: See Item 7) (h) / / Group, in accordance with ss.240.13d-1(b)(1)(ii)(H) Not applicable. ITEM 4. OWNERSHIP. (A) AMOUNT BENEFICIALLY OWNED: Donald R. Head is the beneficial owner of 2,627,345 shares of Common Stock of the Company consisting of (i) 2,025,205 shares held by The Head Revocable Trust of which Mr. Head is the Trustee and a beneficiary, (ii) an option to purchase 301,895 shares of Common Stock from The William and Dorothy Eichbaum Trust Dated November 19, 1986; such option is exercisable anytime during the period ending May 23, 1999, and (iii) an option to purchase 300,245 shares of Common Stock from John M. Redfield Jr. and Linda N. Redfield as Trustees under a Revocable Declaration of Trust Dated October 29, 1982; such option is exercisable anytime during the period ending May 23, 1999. Such amount does not include options to purchase 60,000 shares of Common Stock granted on September 1, 1996 pursuant to the Company's 1996 Stock Option Plan. Such options are exercisable: 50% two years from the date of grant and the remaining 50% three years from the date of grant. The Head Revocable Trust is the beneficial owner of 2,025,205 shares. (B) PERCENT OF CLASS: The 2,627,345 shares reported as beneficially owned by Donald R. Head are equal to 26% of the issued and outstanding shares of Common Stock of the Company on December 31, 1996. The 2,025,205 shares held by The Head Revocable Trust are equal to 20% of such issued and outstanding shares. (C) NUMBER OF SHARES AS TO WHICH SUCH PERSON HAS: (1) Donald R. Head (i) sole power to vote or direct the vote: 2,627,345 (ii) shared power to vote or direct the vote: 0 (iii) sole power to dispose or direct the disposition of: 2,627,345 (iv) shared power to dispose or direct the disposition of: 0 Page 5 of 8 Pages (2) The Head Revocable Trust (i) sole power to vote or direct the vote: 2,025,205 (ii) shared power to vote or direct the vote: 0 (iii) sole power to dispose or direct the disposition of: 2,025,205 (iv) shared power to dispose or direct the disposition of: 0 ITEM 5. OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following / /. Not applicable. ITEM 6. OWNERSHIP OF MORE THAN FIVE PERCENT ON BEHALF OF ANOTHER PERSON. Not applicable. ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY Not applicable. ITEM 8. IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP Not applicable. ITEM 9. NOTICE OF DISSOLUTION OF GROUP Not applicable. ITEM 10. CERTIFICATION Not applicable. Page 6 of 8 Pages SIGNATURE After reasonable inquiry and to the best of our knowledge and belief, we certify that the information set forth in this statement is true, complete and correct. Dated: February 12, 1997 /s/ Donald R. Head ----------------------------------- DONALD R. HEAD THE HEAD REVOCABLE TRUST DATED APRIL 1, 1975 Dated: February 12, 1997 By: /s/ Donald R. Head -------------------------------- Donald R. Head, Trustee Page 7 of 8 Pages EXHIBIT 1 JOINT FILING AGREEMENT DONALD R. HEAD and THE HEAD REVOCABLE TRUST DATED APRIL 1, 1975 hereby agree and consent to the joint filing on their behalf of the foregong Schedule 13G relating to their beneficial ownership of the Common Stock of Capital Title Group, Inc. Dated: February 12, 1997 /s/ Donald R. Head ----------------------------------- DONALD R. HEAD THE HEAD REVOCABLE TRUST DATED APRIL 1, 1975 Dated: February 12, 1997 By: /s/ Donald R. Head -------------------------------- Donald R. Head, Trustee Page 8 of 8 Pages -----END PRIVACY-ENHANCED MESSAGE-----