-----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, SFipUr6LcVW1KQ7VXZhIa8trWQMWuE+T54O7BgljlAPZJH4nC7mkg5OE6H5g4zMj aPWUnxIiF3X2A6yueOCHwQ== 0000950134-04-002056.txt : 20040217 0000950134-04-002056.hdr.sgml : 20040216 20040217101107 ACCESSION NUMBER: 0000950134-04-002056 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20040217 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HARRIS DAVID O CENTRAL INDEX KEY: 0001248733 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 4832 GRAND AVE CITY: DULUTH STATE: MN ZIP: 55807 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: IKONICS CORP CENTRAL INDEX KEY: 0001083301 STANDARD INDUSTRIAL CLASSIFICATION: PHOTOGRAPHIC EQUIPMENT & SUPPLIES [3861] IRS NUMBER: 410730027 FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-58319 FILM NUMBER: 04604242 BUSINESS ADDRESS: STREET 1: 4832 GRAND AVENUE CITY: DULUTH STATE: MN ZIP: 55807 BUSINESS PHONE: 2186282217 MAIL ADDRESS: STREET 1: 4832 GRAND AVENUE CITY: DULUTH STATE: MN ZIP: 55807 FORMER COMPANY: FORMER CONFORMED NAME: CHROMALINE CORP DATE OF NAME CHANGE: 19990405 SC 13G 1 c82824sc13g.txt SCHEDULE 13G OMB APPROVAL -------------------------- OMB Number: 3235-0145 Expires: December 31, 2005 Estimated average burden hours per response......11 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, DC 20549 SCHEDULE 13G UNDER THE SECURITIES EXCHANGE ACT OF 1934 (AMENDMENT NO. __)* Ikonics Corporation - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 45172K102 - -------------------------------------------------------------------------------- (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: [ ] Rule 13d-1(b) [ ] Rule 13d-1(c) [X] 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. SEC 1745 (12-02) CUSIP NO. 45172K102 13G Page 2 of 5 Pages - -------------------------------------------------------------------------------- 1. Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). David O. Harris - -------------------------------------------------------------------------------- 2. Check the Appropriate Box if a Member of a Group (See Instructions) Not Applicable (a) [ ] ----------------------------------------------------------------- (b) [ ] ----------------------------------------------------------------- - -------------------------------------------------------------------------------- 3. SEC Use Only - -------------------------------------------------------------------------------- 4. Citizenship or Place of Organization United States - -------------------------------------------------------------------------------- Number of 5. Sole Voting Power Shares 63,893 ----------------------------------------------------- Beneficially 6. Shared Voting Power Owned by 0 ----------------------------------------------------- Each 7. Sole Dispositive Power Reporting 63,893 ----------------------------------------------------- Person With: 8. Shared Dispositive Power 0 - -------------------------------------------------------------------------------- 9. Aggregate Amount Beneficially Owned by Each Reporting Person 63,893 - -------------------------------------------------------------------------------- 10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions) N/A - -------------------------------------------------------------------------------- 11. Percent of Class Represented by Amount in Row (9) 5.1% - -------------------------------------------------------------------------------- 12. Type of Reporting Person (See Instructions) IN - -------------------------------------------------------------------------------- CUSIP NO. 45172K102 13G Page 3 of 5 Pages - -------------------------------------------------------------------------------- ITEM 1. (a) Name of Issuer Ikonics Corporation (b) Address of Issuer's Principal Executive Offices 4832 Grand Avenue Duluth, MN 55807 ITEM 2. (a) Name of Person Filing David O. Harris (b) Address of Principal Business Office or, if none, Residence P.O. Box 32833 Minneapolis, Minnesota 55432 (c) Citizenship United States (d) Title of Class of Securities Common Stock (e) CUSIP Number 45172K102 ITEM 3. IF THIS STATEMENT IS FILED PURSUANT TO SECTIONS 240.13D-1(b) OR 240.13D-2(b) OR (c), 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 of 1940. (e) [ ] An investment adviser in accordance with Section 240.13d-1(b)(1)(ii)(E). (f) [ ] An employee benefit plan or endowment fund in accordance with Section 240.13d-1(b)(1)(ii)(F). (g) [ ] A parent holding company or control person in accordance with Section 240.13d-1(b)(1)(ii)(G). (h) [ ] A savings association as defined in Section 3(b) of the Federal Deposit Insurance Act. (i) [ ] 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. (j) [ ] Group, in accordance with Section 240.13d-1(b)(1)(ii)(J). CUSIP NO. 45172K102 13G Page 4 of 5 Pages - -------------------------------------------------------------------------------- ITEM 4. OWNERSHIP (a) Amount Beneficially Owned 63,893 (b) Percent of Class 5.1% (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote 63,893 (ii) Shared power to vote or to direct the vote 0 (iii) Sole power to dispose or to direct the disposition of 63,893 (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 [ ]. 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 CUSIP NO. 45172K102 13G Page 5 of 5 Pages - -------------------------------------------------------------------------------- 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. February 17, 2004 --------------------------------------- Date /s/ David O. Harris --------------------------------------- Signature David O. Harris --------------------------------------- Name/Title The original statement shall be signed by each person on whose behalf the statement is filed or his authorized representative. If the statement is signed on behalf of a person by his authorized representative other than an executive officer or general partner of the filing person, evidence of the representative's authority to sign on behalf of such person shall be filed with the statement, provided, however, that a power of attorney for this purpose which is already on file with the Commission may be incorporated by reference. The name and any title of each person who signs the statement shall be typed or printed beneath his signature. NOTE: Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Section 240.13d-7 for other parties for whom copies are to be sent. ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT CONSTITUTE FEDERAL CRIMINAL VIOLATIONS (SEE 18 U.S.C. 1001) -----END PRIVACY-ENHANCED MESSAGE-----