-----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, KTdBmFYda0faU1qnMrFSo76rAZPZK+dVdGb7GVNc9KCiXvbuqiVT/Yhr2aho4nIG pTyGlNy4Og0tOtLnBElrjA== 0000892569-03-002191.txt : 20030922 0000892569-03-002191.hdr.sgml : 20030922 20030922122939 ACCESSION NUMBER: 0000892569-03-002191 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20030922 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: LEVASSEUR GILBERT E JR REVOCABLE TRUST CENTRAL INDEX KEY: 0001130428 FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: C/O 26 CORPORATE PLAZA SUITE 280 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 MAIL ADDRESS: STREET 1: C/O 26 CORPORATE PLAZA STREET 2: SUITE 280 CITY: NEWPORT BEACH STATE: CA ZIP: 92660 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: JONES SODA CO CENTRAL INDEX KEY: 0001083522 STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080] IRS NUMBER: 911696175 STATE OF INCORPORATION: WA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: 1934 Act SEC FILE NUMBER: 005-58549 FILM NUMBER: 03903792 BUSINESS ADDRESS: STREET 1: 234 9TH AVE NORTH CITY: SEATTLE STATE: WA ZIP: 98109 BUSINESS PHONE: 8006566050 MAIL ADDRESS: STREET 1: 234 9TH AVE N CITY: SEATTLE STATE: WA ZIP: 98109 FORMER COMPANY: FORMER CONFORMED NAME: URBAN JUICE & SODA CO LTD /WY/ DATE OF NAME CHANGE: 19990407 SC 13G 1 a93215sc13g.htm SCHEDULE 13G Jones Soda Co.
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934
(Amendment No. )*

JONES SODA CO.

(Name of Issuer)

COMMON STOCK, NO PAR VALUE

(Title of Class of Securities)

78023P106

(Cusip Number)

September 19, 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)

        x Rule 13d-1 (c)

        o 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 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).

 

 

             
13G
CUSIP No. 48023P106 Page 1 of 5
  1. Name of Reporting Person:
I.R.S. Identification Nos. of above persons (entities only):
GILBERT E. LEVASSEUR, JR REVOCABLE TRUST		  
  2. Check the Appropriate Box if a Member of a Group:
    (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:
978,900
6. Shared Voting Power:
-0-
7. Sole Dispositive Power:
978,900
8.Shared Dispositive Power:
0
  9.Aggregate Amount Beneficially Owned by Each Reporting Person:
978,900
  10.Check if the Aggregate Amount in Row (9) Excludes Certain Shares:
o
  11.Percent of Class Represented by Amount in Row (9):
4.94%
  12.Type of Reporting Person:
OO

2

 

         
Item 1.        
    (a)   Name of Issuer: JONES SODA CO.
         
    (b)   Address of Issuer’s Principal Executive Offices: 234 9TH Avenue North, Seattle, WA 98109
         
Item 2.        
    (a)   Name of Person Filing: Gilbert E. LeVasseur, Jr Revocable Trust
         
    (b)   Address of Principal Business Office or, if none, Residence: 26 Corporate Plaza, Suite 280, Newport Beach, CA 92660
         
    (c)   Citizenship: USA
         
    (d)   Title of Class of Securities: Common Stock, No Par Value
         
    (e)   CUSIP Number: 48023P106
             
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:
             
    (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).
             
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: 978,900
 
  (b)   Percent of class: 4.94%
 
  (c)   Number of shares as to which the person has:

  (i)   Sole power to vote or to direct the vote: 978,900
 
  (ii)   Shared power to vote or to direct the vote: -0-
 
  (iii)   Sole power to dispose or to direct the disposition of: 978,900
 
  (iv)   Shared power to dispose or to direct the disposition of: –0-

Instruction. For computations regarding securities which represent a right to acquire an underlying security see §240.13d3(d)(1).

     
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 [ X ].

Instruction:Dissolution of a group requires a response to this item.

     
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.

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

The reporting person hereby makes the following certification:

By signing below I certify that, to the best of my knowledge and belief, the securities referred to above were acquired and are held in the ordinary course of business and were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect.

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.

     
    September 19, 2003
Date
     
    BY: /s/ Gilbert E. LeVasseur, Sole Trustee
Signature
     
    GILBERT E. LEVASSEUR JR, REVOCABLE TRUST
Name/Title

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