0001140361-12-052772.txt : 20121227 0001140361-12-052772.hdr.sgml : 20121227 20121227113210 ACCESSION NUMBER: 0001140361-12-052772 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20121226 FILED AS OF DATE: 20121227 DATE AS OF CHANGE: 20121227 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Roberson Mark Daniel CENTRAL INDEX KEY: 0001415593 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-51572 FILM NUMBER: 121286697 MAIL ADDRESS: STREET 1: 1020 CREWS ROAD STREET 2: SUITE J CITY: MATTHEWS STATE: NC ZIP: 28106 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: POKERTEK, INC. CENTRAL INDEX KEY: 0001302177 STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS MANUFACTURING INDUSTRIES [3990] IRS NUMBER: 611455265 STATE OF INCORPORATION: NC FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 1150 CREWS ROAD STREET 2: SUITE F CITY: MATTHEWS STATE: NC ZIP: 28105 BUSINESS PHONE: 7048490860 MAIL ADDRESS: STREET 1: 1150 CREWS ROAD STREET 2: SUITE F CITY: MATTHEWS STATE: NC ZIP: 28105 FORMER COMPANY: FORMER CONFORMED NAME: POKERTEK INC DATE OF NAME CHANGE: 20040901 4 1 doc1.xml FORM 4 X0306 4 2012-12-26 0 0001302177 POKERTEK, INC. PTEK 0001415593 Roberson Mark Daniel 1150 CREWS ROAD, SUITE F MATTHEWS NC 28105 0 1 0 0 CEO & CFO Common Stock 2012-12-26 4 P 0 4000 1.08 A 243365 D /s/ Mark D. Roberson 2012-12-27