FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 08/05/2010 |
3. Issuer Name and Ticker or Trading Symbol
COMMUNICATION INTELLIGENCE CORP [ CICI.OB ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock, par value $0.01 | 62,283,562 | I(1)(6) | By Phoenix Venture Fund LLC |
Common Stock, par value $0.01 | 62,283,562 | I(1)(6) | By SG Phoenix Ventures LLC |
Common Stock, par value $0.01 | 2,792,429 | I(2)(6) | By SG Phoenix LLC |
Common Stock, par value $0.01 | 19,000 | D |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Series B Preferred Stock | (4) | (5) | Common Stock | 78,417,367 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Series B Preferred Stock | (4) | (5) | Common Stock | 78,417,367 | $0.06 | I(1)(6) | By SG Phoenix Ventures LLC |
Series B Preferred Stock | (4) | (5) | Common Stock | 334,967 | $0.06 | I(3)(6) | By Andax LLC |
Warrants (Right to buy) | 12/31/2009 | 12/31/2012 | Common Stock | 1,162,824 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 03/31/2010 | 03/31/2013 | Common Stock | 1,162,824 | $0.06 | I(1)(6) | By SG Phoenix Ventures LLC |
Warrants (Right to buy) | 03/31/2010 | 03/31/2013 | Common Stock | 1,160,469 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 03/31/2010 | 03/31/2013 | Common Stock | 1,160,469 | $0.06 | I(1)(6) | By SG Phoenix Ventures LLC |
Warrants (Right to buy) | 05/04/2010 | 05/04/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 05/04/2010 | 05/04/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By SG Phoenix Ventures LLC |
Warrants (Right to buy) | 05/04/2010 | 05/04/2013 | Common Stock | 20,833 | $0.06 | I(3)(6) | By Andax LLC |
Warrants (Right to buy) | 05/19/2010 | 05/19/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 05/19/2010 | 05/19/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 05/19/2010 | 05/19/2013 | Common Stock | 20,833 | $0.06 | I(3)(6) | By Andax LLC |
Warrants (Right to buy) | 06/03/2010 | 06/03/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 06/03/2010 | 06/03/2013 | Common Stock | 1,041,667 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 06/03/2010 | 06/03/2013 | Common Stock | 20,833 | $0.06 | I(3)(6) | By Andax LLC |
Warrants (Right to buy) | 06/30/2010 | 06/30/2013 | Common Stock | 4,766,943 | $0.06 | I(1)(6) | By Phoenix Venture Fund LLC |
Warrants (Right to buy) | 06/30/2010 | 06/30/2013 | Common Stock | 4,766,943 | $0.06 | I(1)(6) | By SG Phoenix Ventures LLC |
Warrants (Right to buy) | 06/30/2010 | 06/30/2013 | Common Stock | 71,409 | $0.06 | I(3)(6) | By Andax LLC |
Warrants (Right to buy) | 08/05/2010 | 08/05/2013 | Common Stock | 4,024,414 | $0.06 | I(2)(6) | By SG Phoenix LLC |
Explanation of Responses: |
1. The securities are owned directly by Phoenix Venture Fund LLC (the "Fund") and may be deemed to be indirectly beneficially owned by SG Phoenix Ventures LLC ("SGPV"), the managing member of the Fund, and by Mr. Goren, the co-manager of SGPV. |
2. The securities are owned directly by SG Phoenix LLC ("SG Phoenix") and may be deemed to be indirectly beneficially owned by Mr. Goren, a member of SG Phoenix. |
3. The securities are owned directly by Andax LLC and may be deemd to be indirectly beneficially owned by Mr. Goren, the managing member of Andax LLC. |
4. Each share of Series Preferred Stock of the Issuer is convertible at any time, at the holder's election, into shares of Common Stock at a conversion price of $0.06 per share, subject to adjustment for stock dividends, splits, combinations and similar events. |
5. Each share of Series B Preferred Stock shall automatically convert into shares of Common Stock at the then applicable conversion rate upon the written consent of the holders of a majority of the then outstanding shares of Series B Preferred Stock. |
6. This filing shall not be deemed as an admission by Mr. Goren that Mr. Goren is, for purposes of Section 16 of the Securities Exchange Act of 1934 or otherwise, the beneficial owner of any equity securities covered by this statement. Mr. Goren disclaims any beneficial ownership of all of the securities held by the Fund, SGPV, SG Phoenix and Andax LLC, except to the extent of his pecuniary interest, if any, in such securities. |
/s/ Andrea Goren | 08/17/2010 | |
** 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 5 (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. |