FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
Form 3 Holdings Reported. | |||||||||||||||||
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Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Trycera Financial, Inc. [ TRYF ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2008 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock, par value $.001 | 12/29/2008 | P4 | 1,710,000 | A | $0(1) | 1,710,000 | I | Sagoso Capital | |||||||
Common Stock, par value $.001 | 70,000 | I | Curo Capital | ||||||||||||
Common Stock, par value $.001 | 635,000 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | ||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Warrants | (2) | 12/29/2008 | 4P | 125,000 | 09/30/2005 | 12/31/2012 | Common Stock | 125,000 | (1) | 125,000 | I | Sagoso Capital | ||
Warrants | (3) | 12/29/2008 | 4P | 50,000 | 04/18/2006 | 06/30/2013 | Common Stock | 50,000 | (1) | 50,000 | I | Sagoso Capital | ||
Warrants | (4) | 12/29/2008 | 4P | 25,000 | 02/05/2007 | 02/28/2014 | Common Stock | 25,000 | (1) | 25,000 | I | Sagoso Capital | ||
Warrants | (5) | 12/29/2008 | 4P | 150,000 | 07/03/2007 | 12/31/2014 | Common Stock | 150,000 | (1) | 150,000 | I | Sagoso Capital | ||
Warrants | (5) | 12/29/2008 | 4P | 280,000 | 10/01/2007 | 12/31/2014 | Common Stock | 280,000 | (1) | 280,000 | I | Sagoso Capital | ||
Warrants | (5) | 10/01/2007 | 12/31/2014 | Common Stock | 35,000 | 35,000 | I | Curo Capital | ||||||
Options | $0.25 | 05/27/2005 | 05/27/2014 | Common Stock | 50,000 | 50,000 | D | |||||||
Options | $0.75 | 05/27/2006 | 05/27/2015 | Common Stock | 50,000 | 50,000 | D | |||||||
Options | $1 | 05/27/2007 | 05/27/2016 | Common Stock | 50,000 | 50,000 | D | |||||||
Options | $1.03 | 05/27/2008 | 05/27/2017 | Common Stock | 50,000 | 50,000 | D | |||||||
Warrants | (4) | 03/01/2007 | 02/28/2014 | Common Stock | 32,500 | 32,500 | D | |||||||
Warrants | (3) | 05/03/2006 | 06/30/2013 | Common Stock | 10,000 | 10,000 | D | |||||||
Warrants | (2) | 12/19/2005 | 12/31/2012 | Common Stock | 25,000 | 25,000 | D |
Explanation of Responses: |
1. All shares and warrants were purchased for a total of $1.00. |
2. The warrants are exercisable at $1.25 per share, with an incentive to exercise early at $1.125 per share after December 31, 2007, through December 31, 2009. |
3. The warrants are exercisable at $1.25 per share, with an incentve to exercise early at $1.125 per share after June 30, 2008, thorugh June 30, 2010. |
4. The warrants are exercisable at $1.25 per share, with incentives to exercise early: (i) at $1.00 per share until February 28, 2009 and (ii)at $1.125 per share after February 28, 2009, through February 28, 2011. |
5. The warrants are exercisable at $.3125 per share, with incentives to exercise early: (i)at $.25 per share until December 31, 2009; and (ii) at $.28125 per share after December 31, 2009 through December 31, 2011. |
/s/ Luan Dang | 02/18/2009 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
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 Number. |