-----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, EDxM4l5eIZ7Yi88B6uLcG0+pNCEdX/fi6O/uyx3mvmsjHj0oggFEhUQid1h7cgjV xzzsnJ8/cWVVuBLHxLQ6gg== 0001015325-06-000344.txt : 20060829 0001015325-06-000344.hdr.sgml : 20060829 20060829112630 ACCESSION NUMBER: 0001015325-06-000344 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20060829 DATE AS OF CHANGE: 20060829 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: INTERLEUKIN GENETICS INC CENTRAL INDEX KEY: 0001037649 STANDARD INDUSTRIAL CLASSIFICATION: IN VITRO & IN VIVO DIAGNOSTIC SUBSTANCES [2835] IRS NUMBER: 943123681 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-53249 FILM NUMBER: 061060944 BUSINESS ADDRESS: STREET 1: 135 BEAVER ST CITY: WATHAM STATE: MA ZIP: 02452 BUSINESS PHONE: 1-781-398-0700 MAIL ADDRESS: STREET 1: 135 BEAVER ST CITY: WATHAM STATE: MA ZIP: 02452 FORMER COMPANY: FORMER CONFORMED NAME: MEDICAL SCIENCE SYSTEMS INC DATE OF NAME CHANGE: 19971003 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: PETERSON JEFFREY CENTRAL INDEX KEY: 0001085102 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: PALM TOWER BUILDING STREET 2: 1343 MAIN STREET #301 CITY: SARSOTA STATE: FL ZIP: 34236 BUSINESS PHONE: 94133015598 MAIL ADDRESS: STREET 1: PALM TOWER BUILING STREET 2: 1343 MAIN STREET #301 CITY: SARASOTA STATE: FL ZIP: 34236 SC 13G 1 sch13g.txt SCHEDULE 13G UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. ______)* Interleukin Genetics, Inc. ____________________________________________________________ (Name of Issuer) Common Stock, $.001 par value per share ____________________________________________________________ (Title of Class of Securities) 458738101 ______________________________________ (CUSIP Number) August 23, 2006 ____________________________________________________________ (Date of Event Which Requires Filing of this Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [_] Rule 13d-1(b) [X] Rule 13d-1(c) [ ] Rule 13d-1(d) *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 on the remainder of this cover page shall not be deemed to be "filed" for the purpose of Section 18 of the Exchange Act or otherwise subject to the liabilities of that section of the Exchange Act but shall be subject to all other provisions of the Exchange Act (however, see the Notes). SCHEDULE 13G - ------------------------------------------------------------ CUSIP No.: 458738101 - ------------------------------------------------------------ 1 NAME OF REPORTING PERSON Jeffrey K. Peterson - ------------------------------------------------------------ 2 CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP (a) [ ] (b) [_] - ------------------------------------------------------------ 3 SEC USE ONLY - ------------------------------------------------------------ 4 CITIZENSHIP OR PLACE OF ORGANIZATION United States - ------------------------------------------------------------ 5 SOLE VOTING POWER 1,742,600 NUMBER OF SHARES ----------------------------------- BENEFICIALLY 6 SHARED VOTING POWER OWNED BY 0 EACH ----------------------------------- REPORTING 7 SOLE DISPOSITIVE POWER PERSON 1,742,600 WITH ----------------------------------- 8 SHARED DISPOSITIVE POWER 0 - ------------------------------------------------------------ 9 AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 1,742,600 - ------------------------------------------------------------ 10 CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES [ ] - ------------------------------------------------------------ 11 PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 7.17% - ------------------------------------------------------------ 12 TYPE OF REPORTING PERSON IN - ------------------------------------------------------------ 2 SCHEDULE 13G - ------------------------------------------------------------ CUSIP No.: 458738101 Item 1. (a) Name of Issuer: Interleukin Genetics, Inc. (b) Address of Issuer's Principal Executive Offices: 135 Beaver Street Waltham, MA 02452 Item 2. (a) Name of Person Filing: Jeffrey K. Peterson (b) Address of Principal Business Office or, if none, Residence: 1707 Waldenmere Street Sarasota, FL 34239 (c) Citizenship: United States Citizen (d) Title of Class of Securities: Common Stock, $.001 par value per share (the "Common Stock") (e) CUSIP Number: 458738101 Item 3. If this statement is filed pursuant to 240.13d-1(b) or 240.13d-2(b) or (c), check whether the person filing is a: Not applicable 3 Item 4. Ownership. Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1. (a) Amount beneficially owned: As of August 23, 2006: Mr. Peterson was the beneficial owner of 1,742,600 shares of the issuer's Common Stock. (b) Percent of class: As of August 23, 2006: The 1,742,600 shares owned by Mr. Peterson constituted 7.17% of the shares outstanding. (c) Number of shares as to which the person has: (i) Sole power to vote or to direct the vote: Mr. Peterson has the sole power to vote or direct the vote as to the 1,742,600 shares owned by him. (ii) Shared power to vote or to direct the vote: N/A (iii) Sole power to dispose or to direct the disposition of: Mr. Peterson has the sole power to dispose or to direct the disposition of the 1,742,600 shares owned by him. (iv) Shared power to dispose or to direct the disposition of: N/A 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 [ ]. 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. 4 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. SIGNATURE After reasonable inquiry and to the best of my knowledge and belief, I certify that the information set forth in this statement is true, complete and correct. Dated: August 29, 2006 /S/ Jeffrey K. Peterson __________________________________ Jeffrey K. Peterson 5 -----END PRIVACY-ENHANCED MESSAGE-----