X0304 4 2011-08-20 0 0001001463 ACACIA AUTOMOTIVE INC acca 0001385150 Sample Steven L 3512 E. SILVER SPRINGS BLVD - #243 OCALA FL 34470 1 1 1 0 CEO & President Common Stock 2011-08-20 4 G 0 200000 0 D 5634600 D Shares gifted to bona fide charity. Shares given as bona fide gifts. Reporting Person disclaims any beneficial ownership in securities held by others, and disclaims beneficial ownership of any person in his securities. /s/ Steven L. Sample 2011-09-26