-----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, PajSGt25izbo9Jbq4f2PJtzlR+9yAkZ9P2fvQmkPWlWQJqSDAOly/mE11DZI3VCy Y+zfcmsKwfU5MoNAOSfefA== 0001096906-05-000411.txt : 20050804 0001096906-05-000411.hdr.sgml : 20050804 20050803181926 ACCESSION NUMBER: 0001096906-05-000411 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050804 DATE AS OF CHANGE: 20050803 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: Q COMM INTERNATIONAL INC CENTRAL INDEX KEY: 0001102901 STANDARD INDUSTRIAL CLASSIFICATION: TELEPHONE COMMUNICATIONS (NO RADIO TELEPHONE) [4813] IRS NUMBER: 884058493 STATE OF INCORPORATION: UT FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-58803 FILM NUMBER: 05997063 BUSINESS ADDRESS: STREET 1: 1145 SOUTH 1680 WEST CITY: OREM STATE: UT ZIP: 84058 BUSINESS PHONE: 8012264222 MAIL ADDRESS: STREET 1: 1145 SOUTH 1680 WEST CITY: OREM STATE: UT ZIP: 84058 FORMER COMPANY: FORMER CONFORMED NAME: AZORE ACQUISITION CORP DATE OF NAME CHANGE: 20000110 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Jurika Family Trust, U/A 1989 CENTRAL INDEX KEY: 0001324520 IRS NUMBER: 000000000 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 2030 FRANKLIN STREET, SUITE 210 CITY: OAKLAND STATE: CA ZIP: 94612 BUSINESS PHONE: 801-521-3200 MAIL ADDRESS: STREET 1: 2030 FRANKLIN STREET, SUITE 210 CITY: OAKLAND STATE: CA ZIP: 94612 SC 13G/A 1 qcomm13g070705.htm Q Comm Schedule 13G



 
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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. 1)*


Q COMM INTERNATIONAL, INC.
(Name of Issuer)

COMMON STOCK
(Title of Class of Securities)

74727M306
(CUSIP Number)

July 7, 2005
(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 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).


CUSIP No. 74727M306



 
1. Names of Reporting Persons. JURIKA FAMILY TRUST, U/A 1989
 
 
I.R.S. Identification Nos. of above persons (entities only).
 
2. Check the Appropriate Box if a Member of a Group (See Instructions)
 
(a)
 
(b) X
 
 
3. SEC Use Only
 
 
4. Citizenship or Place of Organization—UNITED STATES 
 
Number of Shares Beneficially Owned by Each Reporting Person With
5.
Sole Voting Power---1,032,850. These shares include, 548,170 shares of common stock, 479,680 shares issuable upon an immediately exercisable warrant held by the Jurika Family Trust (the “Trust”) and 5,000 shares issuable upon an immediately exercisable option held by the Trust.
 
6.
Shared Voting Power---0.
     
 
7.
Sole Dispositive Power—1,032,850. These shares include, 548,170 shares of common stock, 479,680 shares issuable upon an immediately exercisable warrant held by the Trust and 5,000 shares issuable upon an immediately exercisable option held by the Trust.
 
8.
Shared Dispositive Power---0.
     
9. Aggregate Amount Beneficially Owned by Each Reporting Person---1,032,850
 
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See Instructions)
 
11. Percent of Class Represented by Amount in Row (9) 17.5%
 
12. Type of Reporting Person (See Instructions) OO (family trust)
 
 
 
 
 

 
 

Item 1.
       
 
(a)
Name of Issuer
 
         
   
Q COMM INTERNATIONAL, INC.
 
         
 
(b)
Address of Issuer’s Principal Executive Offices
 
         
   
510 EAST TECHNOLOGY AVENUE
BUILDING C, OREM, UTAH 84097
 
Item 2.
       
 
(a)
Name of Person Filing
 
         
   
JURIKA FAMILY TRUST, U/A 1989
 
         
 
(b)
Address of Principal Business Office or, if none, Residence
 
         
   
2030 FRANKLIN STREET, SUITE 210 OAKLAND, CALIFORNIA 94612
 
       
 
(c)
Citizenship
 
         
   
UNITED STATES (place of organization)
 
         
 
(d)
Title of Class of Securities
 
         
   
COMMON STOCK
 
         
 
(e)
CUSIP Number
 
         
   
74727M306
 
   
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)
[  ]
Broker or dealer registered under section 15 of the Act (15 U.S.C. 78o).
       
 
(b)
[  ]
Bank is defined in section 3(a)(6) of the Act (15 U.S.C. 78c).
       
 
(c)
[  ]
Insurance company as defined in section 3(a)(19) of the Act (15 U.S.C. 78c).
       
 
(d)
[  ]
Investment company registered under section 8 of the Investment Company Act of 1940 (15 U.S.C. 80a-8).
       
 
(e)
[  ]
An investment adviser in accordance with § 240.13d-1(b)(1)(ii)(E);
       
 
(f)
[  ]
An employee benefit plan or endowment fund in accordance with § 240.13d-1(b)(1)(ii)(F);
       
 
(g)
[  ]
A parent holding company or control person in accordance with § 240.13d-1(b)(1)(ii)(G);
       
 
(h)
[  ]
A savings associations as defined in Section 3(b) of the Federal Deposit Insurance Act (12 U.S.C. 1813);
       
 
(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 (15 U.S.C. 80a-3);
       
 
(j)
[  ]
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:               1,032,850         .
     
 
(b)
Percent of class:  ________17.5%_________
     
 
(c)
Number of shares as to which the person has:
         
   
(i)
Sole power to vote or to direct the vote              1,032,850          
 
         
   
(ii)
Shared power to vote or to direct the vote                          0.            
 
         
   
(iii)
Sole power to dispose or to direct the disposition of             1,032,850.         
         
   
(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

N/A

Item 6.
Ownership of More than Five Percent on Behalf of Another Person.

William K. Jurika and Michelle Jurika are beneficiaries of the Jurika Family Trust, U/A 1989.

Item 7.
Identification and Classification of the Subsidiary Which Acquired the Security Being  Reported on By the Parent Holding Company or Control Person.

N/A

Item 8.
Identification and Classification of Members of the Group.

N/A

Item 9.
Notice of Dissolution of Group

N/A

Item 10.
Certification
 
(b)  
 The following certification shall be included if the statement is filed pursuant to § 240.13d-1(c):
 
By signing below I certify that, to the best of my knowledge and belief, the securities referred to above 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.

Date: August 2, 2005

Ronald S. Poelman                                               
Attorney-in-fact, Jurika Family Trust, U/A 1989 

Attention: Intentional misstatements or omissions of fact constitute Federal criminal violations
(See 18.U.S.C.)





 
 
 
 
 


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