-----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, InW3vrZleDAUlFHwmJIOTn54O4MpYcDsHSpxifQ/pPueE8o5DSohuFeah5Z24rAK lL7GqpVD6dd8cPIdbDuylQ== 0001060369-01-000020.txt : 20010214 0001060369-01-000020.hdr.sgml : 20010214 ACCESSION NUMBER: 0001060369-01-000020 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010213 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: RELIV INTERNATIONAL INC CENTRAL INDEX KEY: 0000768710 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 371172197 STATE OF INCORPORATION: IL FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-48267 FILM NUMBER: 1536146 BUSINESS ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 BUSINESS PHONE: 3145379715 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD STREET 2: P O BOX 405 CITY: CHESTERFIELD STATE: MO ZIP: 63006-0405 FORMER COMPANY: FORMER CONFORMED NAME: AMERICAN LIFE INVESTORS INC DATE OF NAME CHANGE: 19920315 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HASTINGS CARL W CENTRAL INDEX KEY: 0000903496 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD CITY: CHESTERFIELD STATE: MO ZIP: 63005 BUSINESS PHONE: 314537 MAIL ADDRESS: STREET 1: 136 CHESTERFIELD INDUSTRIAL BLVD CITY: CHESTERFIELD STATE: MO ZIP: 63005 SC 13G 1 0001.txt SCHEDULE 13G ------------------------------- / OMB APPROVAL / ------------------------------- / OMB Number: 3235-0145 / / Expires: December 31, 1997 / / Estimated average burden / / hours per response ... 14.90/ ------------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 6)* RELIV' INTERNATIONAL, INC. ------------------------------------ (Name of Issuer) Common Stock, No Par Value ------------------------------------ (Title of Class of Securities) 75952 R 100 ------------- (CUSIP Number) Check the following box if a fee is being paid with this statement. [_] (A fee is not required only if the filing person: (1) has a previous statement on file reporting beneficial ownership of more than five percent of the class of securities described in Item 1; and (2) has filed no amendment subsequent thereto reporting beneficial ownership of five percent or less of such class.) (See Rule 13d-7.) *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). SEC 1745 (2-95) - --------------------------- --------------------- CUSIP NO. 75952 R 100 13G PAGE 2 OF 4 PAGES - --------------------------- --------------------- - -------------------------------------------------------------------------------- NAME OF REPORTING PERSON 1 S.S. or I.R.S. IDENTIFICATION NO. OF ABOVE PERSON Carl W. Hastings - -------------------------------------------------------------------------------- CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* 2 (a) [_] (b) [_] - -------------------------------------------------------------------------------- SEC USE ONLY 3 - -------------------------------------------------------------------------------- CITIZENSHIP OR PLACE OF ORGANIZATION 4 United States - -------------------------------------------------------------------------------- SOLE VOTING POWER 5 NUMBER OF 840,247 SHARES ----------------------------------------------------------- SHARED VOTING POWER BENEFICIALLY 6 OWNED BY ----------------------------------------------------------- EACH SOLE DISPOSITIVE POWER 7 REPORTING 840,247 PERSON ----------------------------------------------------------- SHARED DISPOSITIVE POWER WITH 8 - -------------------------------------------------------------------------------- AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 9 840,247 - -------------------------------------------------------------------------------- CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* 10 - -------------------------------------------------------------------------------- PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 11 8.50% - -------------------------------------------------------------------------------- TYPE OF REPORTING PERSON* 12 IN - -------------------------------------------------------------------------------- *SEE INSTRUCTIONS BEFORE FILLING OUT! CUSIP NO. 75952 R 100 13G PAGE 3 OF 4 PAGES ITEM 1. (a) Name of Issuer Reliv' International, Inc. (b) Address of Issuer's Principal Executive Offices 136 Chesterfield Industrial Boulevard Chesterfield, Missouri 63005 ITEM 2. (a) Name of Person Filing Carl W. Hastings (b) Address of Principal Business Office or, if none, Residence 136 Chesterfield Industrial Boulevard Chesterfield, Missouri 63005 (c) Citizenship United States (d) Title of Class of Securities Common Stock, No Par Value (e) CUSIP Number 75952 R 100 ITEM 3. N/A ITEM 4. OWNERSHIP (a) Amount Beneficially Owned 840,247 (b) Percent of Class 8.50% (c) Number of shares as to which such person has: (i) sole power to vote or to direct the vote 840,247 (ii) shared power to vote or to direct the vote -------- CUSIP No. 75952 R 100 13G Page 4 of 4 Pages (iii) sole power to dispose or to direct the disposition of 840,247 (iv) shared power to dispose or to direct the disposition of ------ 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. N/A ITEM 7. IDENTIFICATION AND CLASSIFICATION OF THE SUBSIDIARY WHICH ACQUIRED THE SECURITY BEING REPORTED ON BY THE PARENT HOLDING COMPANY. 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. N/A 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. The filing of this statement shall not be construed as an admission that the undersigned is for the purposes of Section 13(d) or 13(g) of the Act, the beneficial owner of any securities covered by this statement. February 10, 2001 ------------------------------- Date /s/ Carl W. Hastings ------------------------------- Carl W. Hastings -----END PRIVACY-ENHANCED MESSAGE-----