FORM 4 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 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). |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Ruby Creek Resources, Inc. [ RBYC.OB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 11/27/2010 | ||||||||||||||||||||||||||
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 Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price | ||||||
Common Stock | 11/27/2010 | C(1) | 1,110,000 | A | $0.05 | 2,844,877 | I | By Booha Family Partners | ||
Common Stock | 11/27/2010 | X | 1,500,000 | A | $0.05 | 4,344,877 | I | By Booha Family Partners |
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) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Convertible Note | $0.05 | 11/27/2010 | C | 1,110,000 | 11/27/2010(1) | 11/27/2010 | Common Stock | 1,110,000 | $0 | 0 | I | By Booha Family Partners | |||
Warrant (right to purchase) | $0.05 | 11/27/2010 | J(2) | 1,000,000(2) | 11/27/2009 | 11/27/2012 | Common Stock | 1,000,000(2) | $0 | 1,000,000 | I | By Booha Family Partners | |||
Warrant (right to purchase) | $0.05 | 11/27/2010 | J(2) | 300,000(2) | 12/21/2009 | 12/21/2012 | Common Stock | 300,000 | $0 | 300,000 | I | By Booha Family Partners | |||
Warrant (right to purchase) | $0.05 | 11/27/2010 | X | 1,500,000 | 03/23/2010 | 02/23/2015 | Common Stock | 1,500,000 | $0 | 0 | I | By Booha Family Partners |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. Booha Family Partners is the holder of a $50,000 convertible promissory note that matured on November 27, 2010. Upon maturity, Booha converted the principal amount and accrued interest of the note into an aggregate 1,110,000 shares of Company common stock. |
2. Booha Family Partners owns warrants to purchase (i) 1,000,000 shares of common stock and (ii) 300,000 shares of common stock. Each of these warrants had prohibitions upon the exercise of these warrants if the holder and its affiliates together beneficially owned more than 9.999% of the Issuer's outstanding common stock. Such prohibtion may be waived by the holder upon 61 days prior notice to the Issuer. On November 27, 2010, the holder provided such waiver to the Issuer. |
By David Bukzin, By Mark F. Coldwell, By Power of Attorney | 11/30/2010 | |
** 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 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. |