-----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, TIBB15jh/4Ip8HDMrV9uhAwu6xNVOdK/cedvv91DltV/xGI0NVvgzSmyNCGvYTDB CIKRsT0ot59WKDGF+ofVug== 0000906344-01-500033.txt : 20010326 0000906344-01-500033.hdr.sgml : 20010326 ACCESSION NUMBER: 0000906344-01-500033 CONFORMED SUBMISSION TYPE: SC 13G PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20010323 GROUP MEMBERS: DOUGLAS FAMILY TRUST GROUP MEMBERS: DOUGLAS KEVIN GROUP MEMBERS: JAMES & JEAN DOUGLAS IRREVOCAB SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: HANSEN NATURAL CORP CENTRAL INDEX KEY: 0000865752 STANDARD INDUSTRIAL CLASSIFICATION: BOTTLED & CANNED SOFT DRINKS CARBONATED WATERS [2086] IRS NUMBER: 391679918 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G SEC ACT: SEC FILE NUMBER: 005-41221 FILM NUMBER: 1577642 BUSINESS ADDRESS: STREET 1: 2401 E KATELLA AVE STE 650 CITY: ANAHEIM STATE: CA ZIP: 92806 BUSINESS PHONE: 7146344200 MAIL ADDRESS: STREET 1: 2401 EAST KATELLA AVE CITY: ANAHEIM STATE: CA ZIP: 92806 FORMER COMPANY: FORMER CONFORMED NAME: UNIPAC CORP DATE OF NAME CHANGE: 19600201 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: DOUGLAS KEVIN CENTRAL INDEX KEY: 0001132859 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G BUSINESS ADDRESS: STREET 1: 4040 CIVIC CENTER DRIVE CITY: SAN RAFAEL STATE: CA ZIP: 94903 MAIL ADDRESS: STREET 1: 4040 CIVIC CENTER DRIVE CITY: SAN RAFAEL STATE: CA ZIP: 94903 SC 13G 1 han13g.txt SCHEDULE 13G SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 SCHEDULE 13G INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b) (c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2(b) (Amendment No. __) Hansen Natural Corporation -------------------------- (Name of Issuer) Common Stock, $0.005 par value ------------------------------ (Title of Class of Securities) 411310-10-5 ----------- (CUSIP Number) March 15, 2001 (Date of Event Which Requires Filing of This Statement) Check the appropriate box to designate the rule pursuant to which this Schedule is filed: [ ] Rule 13d-1(b) [x] Rule 13d-1(c) [ ] Rule 13d-1(d) CUSIP No. 411310-10-5 SCHEDULE 13G Page 2 of 9 1 Name Of Reporting Person KEVIN DOUGLAS IRS Identification No. Of Above Person 2 Check The Appropriate Box If A Member Of A Group (a) [ ] (b) [x] 3 SEC USE ONLY 4 Citizenship Or Place Of Organization United States 5 Sole Voting Power -0- NUMBER OF SHARES 6 Shared Voting Power 545,400 BENEFICIALLY OWNED BY EACH 7 Sole Dispositive Power -0- REPORTING PERSON WITH 8 Shared Dispositive Power 545,400 9 Aggregate Amount Beneficially Owned By Each Reporting Person 545,400 10 Check Box If The Aggregate Amount In Row (9) Excludes Certain Shares [ ] 11 Percent Of Class Represented By Amount In Row 9 5.4% 12 Type Of Reporting Person* IN CUSIP No. 411310-10-5 SCHEDULE 13G Page 3 of 9 1 Name Of Reporting Person DOUGLAS FAMILY TRUST IRS Identification No. Of Above Person 2 Check The Appropriate Box If A Member Of A Group (a) [ ] (b) [x] 3 SEC USE ONLY 4 Citizenship Or Place Of Organization California 5 Sole Voting Power -0- NUMBER OF SHARES 6 Shared Voting Power 545,400 BENEFICIALLY OWNED BY EACH 7 Sole Dispositive Power -0- REPORTING PERSON WITH 8 Shared Dispositive Power 545,400 9 Aggregate Amount Beneficially Owned By Each Reporting Person 545,400 10 Check Box If The Aggregate Amount In Row (9) Excludes Certain Shares* [ ] 11 Percent Of Class Represented By Amount In Row 9 5.4% 12 Type Of Reporting Person* OO CUSIP No. 411310-10-5 SCHEDULE 13G Page 4 of 9 1 Name Of Reporting Person JAMES DOUGLAS AND JEAN DOUGLAS IRREVOCABLE DESCENDANTS' TRUST IRS Identification No. Of Above Person 2 Check The Appropriate Box If A Member Of A Group (a) [ ] (b) [x] 3 SEC USE ONLY 4 Citizenship Or Place Of Organization California 5 Sole Voting Power -0- NUMBER OF SHARES 6 Shared Voting Power 545,400 BENEFICIALLY OWNED BY EACH 7 Sole Dispositive Power -0- REPORTING PERSON WITH 8 Shared Dispositive Power 545,400 9 Aggregate Amount Beneficially Owned By Each Reporting Person 545,400 10 Check Box If The Aggregate Amount In Row (9) Excludes Certain Shares* [ ] 11 Percent Of Class Represented By Amount In Row 9 5.4% 12 Type Of Reporting Person* OO CUSIP No. 411310-10-5 SCHEDULE 13G Page 5 of 9 Item 1(a). Name of Issuer. Hansen Natural Corporation (the "Issuer"). Item 1(b). Address of Issuer's Principal Executive Offices. 1010 Railroad Street, Corona, CA 92882. Item 2(a). Names of Persons Filing. Reference is made to Item 1 of each of the cover pages of this Schedule, which Items are incorporated by reference herein. Item 2(b). Address of Principal Business Office or, if none, Residence. The address of each reporting person is 4040 Civic Center Drive, Suite 530, San Rafael, CA 94903. Item 2(c). Citizenship. Reference is made to Item 4 of each of the cover pages of this Schedule, which Items are incorporated by reference herein. Item 2(d). Title of Class of Securities. Common stock, $0.005 par value ("Common Stock"). Item 2(e). CUSIP Number. 411310-10-5. Item 3. Type of Reporting Person. Not applicable. Item 4. Ownership. Reference is made to Items 5-9 and 11 of each of the cover pages to this Schedule, which Items are incorporated by reference herein. According to the Issuer, there were 10,066,389 shares of Common Stock issued and outstanding as of March 1, 2001. As of the date of this filing, the following shares of Common Stock are held directly by the following persons: CUSIP No. 411310-10-5 SCHEDULE 13G Page 6 of 9 Common Stock Person Directly Owned -------------- Kevin Douglas 180,617 Douglas Family Trust 184,167 James Douglas and Jean Douglas Irrevocable Descendants' Trust 180,616 ------- TOTAL 545,400 ======= Each of the reporting persons may be deemed a member of a group that shares voting and dispositive power over all of the above securities. Although the reporting persons are reporting such securities as if they were members of a group, the filing of this Schedule shall not be construed as an admission by any reporting person that such person is a beneficial owner of any securities other than those directly held by such person. Item 5. Ownership of Five Percent or Less of a Class. Not applicable. Item 6. Ownership of More Than Five Percent on Behalf of Another Person. Not applicable. Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Not applicable. Item 8. Identification and Classification of Members of the Group. Not applicable. Item 9. Notice of Dissolution of Group. Not applicable. Item 10. Certification. By signing below, each reporting person certifies that, to the best of such person's knowledge and belief, the securities referred to above were not acquired and are not held for the purpose of or with the effect of changing or influencing the control of the issuer of the securities and were not acquired and are not held in connection with or as a participant in any transaction having that purpose or effect. CUSIP No. 411310-10-5 SCHEDULE 13G Page 7 of 9 Signature After reasonable inquiry and to the best of their knowledge and belief, the undersigned certify that the information set forth in this statement is true, complete and correct. DATED: March 22, 2001. /s/ Kevin Douglas _________________________________ KEVIN DOUGLAS DOUGLAS FAMILY TRUST By /s/ James E. Douglas, Jr. ______________________________ James E. Douglas, Jr., Trustee By /s/ Jean A. Douglas ______________________________ Jean A. Douglas, Trustee JAMES DOUGLAS AND JEAN DOUGLAS IRREVOCABLE DESCENDANTS' TRUST By /s/ Kevin Douglas _____________________________ Kevin Douglas, Trustee By /s/ Michelle Douglas _____________________________ Michelle Douglas, Trustee CUSIP No. 411310-10-5 SCHEDULE 13G Page 8 of 9 EXHIBIT INDEX Exhibit A Joint Filing Undertaking Page 9 CUSIP No. 411310-10-5 SCHEDULE 13G Page 9 of 9 JOINT FILING UNDERTAKING The undersigned, being duly authorized thereunto, hereby execute this agreement as an exhibit to this Schedule 13G to evidence the agreement of the below-named parties, in accordance with rules promulgated pursuant to the Securities Exchange Act of 1934, to file this Schedule and any subsequent amendment jointly on behalf of each of such parties. DATED: March 22, 2001. /s/ Kevin Douglas _________________________________ KEVIN DOUGLAS DOUGLAS FAMILY TRUST By /s/ James E. Douglas, Jr. ______________________________ James E. Douglas, Jr., Trustee By /s/ Jean A. Douglas ______________________________ Jean A. Douglas, Trustee JAMES DOUGLAS AND JEAN DOUGLAS IRREVOCABLE DESCENDANTS' TRUST By /s/ Kevin Douglas _____________________________ Kevin Douglas, Trustee By /s/ Michelle Douglas _____________________________ Michelle Douglas, Trustee -----END PRIVACY-ENHANCED MESSAGE-----