-----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, RHIWHCk7BGF++Y+XvBAE2/7tuYvr2ym9UiO0+FlEQFKOANj7nuTo00gUHXmB+Urd b9CXb3YxLiJ0f0qKEvFBpw== 0001104659-04-001249.txt : 20040120 0001104659-04-001249.hdr.sgml : 20040119 20040120102047 ACCESSION NUMBER: 0001104659-04-001249 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040120 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: CENTIV INC CENTRAL INDEX KEY: 0001044167 STANDARD INDUSTRIAL CLASSIFICATION: WHOLESALE-COMPUTER & PERIPHERAL EQUIPMENT & SOFTWARE [5045] IRS NUMBER: 582033795 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-53091 FILM NUMBER: 04531306 BUSINESS ADDRESS: STREET 1: 998 FOREST EDGE DRIVE CITY: VERNON HILLS STATE: IL ZIP: 60061 BUSINESS PHONE: 8478768300 MAIL ADDRESS: STREET 1: 998 FOREST EDGE DRIVE CITY: VERNON HILLS STATE: IL ZIP: 60061 FORMER COMPANY: FORMER CONFORMED NAME: TEKGRAF INC DATE OF NAME CHANGE: 19970808 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: GUST THOMAS A CENTRAL INDEX KEY: 0001096754 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 200 NORTH FAIRWAY DRIVE STREET 2: SUITE 202 CITY: VERNON HILLS STATE: IL ZIP: 60061 BUSINESS PHONE: 8473610101 MAIL ADDRESS: STREET 1: 321 N CLARK STREET STREET 2: SUITE 202 CITY: VERNON HILLS STATE: IL ZIP: 60061 SC 13G/A 1 a04-1383_1sc13ga.htm SC 13G/A

 

 

UNITED STATES

OMB APPROVAL

 

SECURITIES AND EXCHANGE COMMISSION

OMB Number:
3235-0145

 

Washington, D.C. 20549

Expires:
December 31, 2005

 

SCHEDULE 13G/A

Estimated average burden hours per response. . 11

 

Information to be included in Statements filed pursuant to Rules 13d-1(b), (c), and (d)
and Amendments thereto filed pursuant to Rule 13d-2(b)
Under the Securities Exchange Act of 1934
(Amendment No. 1)*

 

CENTIV, INC.

(Name of Issuer)

 

Common Stock, par value $0.001 per share

(Title of Class of Securities)

 

15233P 10 1

(CUSIP Number)

 

December 31, 2003

(Date of Event Which Requires Filing of this Statement)

 

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

o

Rule 13d-1(b)

o

Rule 13d-1(c)

ý

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 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).

 

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

 



 

 

CUSIP No.  15233P 10 1

 

 

1.

Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only)
Thomas A. Gust

 

 

2.

Check the Appropriate Box if a Member of a Group (See Instructions)

 

 

(a)

o

 

 

(b)

o

 

 

3.

SEC Use Only

 

 

4.

Citizenship or Place of Organization
U.S.A.

 

 

 

Number of
Shares
Beneficially
Owned by
Each
Reporting
Person With

5.

Sole Voting Power
73,300

 

6.

Shared Voting Power
0

 

7.

Sole Dispositive Power
73,300

 

8.

Shared Dispositive Power
0

 

 

9.

Aggregate Amount Beneficially Owned by Each Reporting Person
73,300

 

 

10.

Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)  o

 

 

11.

Percent of Class Represented by Amount in Row (9)
4.4%

 

 

12.

Type of Reporting Person (See Instructions)
IN

 

2



 

Item 1.

 

(a)

Name of Issuer
Centiv, Inc.

 

(b)

Address of Issuer’s Principal Executive Offices
998 Forest Edge Drive Vernon Hills, Illinois 60061

 

Item 2.

 

(a)

Name of Person Filing
Thomas A. Gust

 

(b)

Address of Principal Business Office or, if none, Residence
200 N. Fairway Drive Suite 202 Vernon Hills, IL 60061

 

(c)

Citizenship
U.S.A.

 

(d)

Title of Class of Securities
Common Stock, par value $0.001 per share.

 

(e)

CUSIP Number
15233P 10 1

 

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.

 

(a)

o

Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).

 

(b)

o

Bank as defined in section 3(a)(6) of the Act (15 U.S.C. 78c).

 

(c)

o

Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).

 

(d)

o

Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C 80a-8).

 

(e)

o

An investment adviser in accordance with §240.13d-1(b)(1)(ii)(E);

 

(f)

o

An employee benefit plan or endowment fund in accordance with §240.13d-1(b)(1)(ii)(F);

 

(g)

o

A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);

 

(h)

o

A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);

 

(i)

o

A church plan that is excluded from the definition of an investment company under section 3(c)(14) of the Investment Company Act of 1940 (15 U.S.C. 80a-3);

 

(j)

o

Group, in accordance with §240.13d-1(b)(1)(ii)(J).

 

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:  73,300.

 

 

(b)

Percent of class:  4.4%.

 

 

(c)

Number of shares as to which the person has:

 

 

 

(i)

Sole power to vote or to direct the vote  73,300.

 

 

 

(ii)

Shared power to vote or to direct the vote  0.

 

 

 

(iii)

Sole power to dispose or to direct the disposition of  73,300.

 

 

 

(iv)

Shared power to dispose or to 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   ý.

 

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 or Control Person

This Item 7 is not applicable.

 

Item 8.

Identification and Classification of Members of the Group

This Item 8 is not applicable.

 

Item 9.

Notice of Dissolution of Group

This Item 9 is not applicable.

 

Item 10.

Certification

This Item 10 is not applicable.

 

4



 

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.

 

 

January 16, 2004

 

Date

 

/s/ Thomas A. Gust

 

Signature

 

Thomas A. Gust

 

Name/Title

 

5


-----END PRIVACY-ENHANCED MESSAGE-----