-----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, Gy+ge+DLeqj6bMA5524LSdD7Km+X2dvPpU0F+ryUc3e2AwHtahMo67nuDgz9pbqU xJtRl/ERjibbr2S3DidtHw== 0001005477-08-006966.txt : 20081223 0001005477-08-006966.hdr.sgml : 20081223 20081223165706 ACCESSION NUMBER: 0001005477-08-006966 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20081219 FILED AS OF DATE: 20081223 DATE AS OF CHANGE: 20081223 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PepperBall Technologies, Inc. CENTRAL INDEX KEY: 0001216199 STANDARD INDUSTRIAL CLASSIFICATION: ORDNANCE & ACCESSORIES, (NO VEHICLES/GUIDED MISSILES) [3480] IRS NUMBER: 201978398 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 6142 NANCY RIDGE DRIVE STREET 2: SUITE 101 CITY: SAN DIEGO STATE: CA ZIP: 92121 BUSINESS PHONE: 858-638-0236 MAIL ADDRESS: STREET 1: 6142 NANCY RIDGE DRIVE STREET 2: SUITE 101 CITY: SAN DIEGO STATE: CA ZIP: 92121 FORMER COMPANY: FORMER CONFORMED NAME: Security With Advanced Technology, Inc. DATE OF NAME CHANGE: 20061010 FORMER COMPANY: FORMER CONFORMED NAME: A4S SECURITY, INC. DATE OF NAME CHANGE: 20050602 FORMER COMPANY: FORMER CONFORMED NAME: A4S TECHNOLOGIES INC DATE OF NAME CHANGE: 20030128 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: PUSEY GREGORY CENTRAL INDEX KEY: 0001008071 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32566 FILM NUMBER: 081267975 BUSINESS ADDRESS: STREET 1: 1722 BUFFEHR CREEK RD CITY: VAIL STATE: CO ZIP: 81657 BUSINESS PHONE: 9704792800 MAIL ADDRESS: STREET 1: 106 S UNIVERSITY BLVD., #14 CITY: DENVER STATE: CO ZIP: 80209 4 1 edgar123.xml FORM 4 X0303 4 2008-12-19 0 0001216199 PepperBall Technologies, Inc. PBAL 0001008071 PUSEY GREGORY 106 S. UNIVERSITY BOULEVARD #14 DENVER CO 80209 1 1 0 0 Chairman Common Stock 5504 I By Cambridge Holdings Ltd Common Stock 67244 I By spouse Common Stock 2008-12-19 4 P 0 120000 .10 A 367693 D Common Stock 2008-12-22 4 P 0 40000 .10 A 407693 D Option (Right to Buy) 9.86 2007-05-05 2016-05-04 Common Stock 10000 10000 D Option (Right to Buy) 7.00 2005-10-29 2014-10-28 Common Stock 27174 27174 D Option (Right to Buy) 7.00 2005-03-02 2015-03-01 Common Stock 10870 10870 D Warrant (Right to Buy) 18.00 2005-08-25 2010-07-18 Common Stock 500 1000 D Warrant (Right to Buy) 18.00 2005-08-25 2010-07-18 Common Stock 2500 5000 I By Cambridge Holdings Ltd Warrant (Right to Buy) 9.5 2007-04-01 2010-10-01 Common Stock 6000 12000 D Series B Convertible Preferred Stock 0 2008-09-17 Common Stock 15000 3000 D Warrant (Right to Buy) 18.00 2007-04-01 2010-07-18 Common Stock 3500 7000 I By spouse Warrant (Right to Buy) 9.50 2007-04-01 2010-10-01 Common Stock 7000 14000 I By spouse Series B Convertible Preferred Stock 0 2008-09-17 Common Stock 5250 1050 I By spouse Option (Right to Buy) 2.42 2009-01-16 2018-01-15 Common Stock 25000 25000 D The Reporting Person disclaims beneficial ownership of these securities, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of the securities for purposes of Section 16 or for any other purpose. Includes 2,500 shares of Common Stock issuable upon exercise of warrants, whether or not presently exercisable. Reporting Person is President, director and principal shareholder of Cambridge Holdings Ltd. Includes (a) 14,630 shares of Common Stock held by Reporting Person's spouse as custodian for child, (b) 4,380 shares of Common Stock held by Jill Pusey, IRA, the investment retirement account of the Reporting Person's spouse, (c) 10,500 shares of Common Stock issuable upon exercise of warrants, whether or not presently exercisable, and (d) 5,250 shares of Common Stock issuable upon conversion of Series B Convertible Preferred Stock, whether or not presently convertible, held by Reporting Person's spouse as custodian for child. Does not include 160,750 shares of the issuer's Common Stock held jointly by the Reporting Person and the Reporting Person's spouse and reported elsewhere in this Form 4. Option vests annually in three equal annual installments, beginning on this date. Option held by Gregory Pusey IRA. Held by the Reporting Person's spouse as custodian for the Reporting Person's child. No expiration date. Each share of the Series B Convertible Preferred Stock is for no further consideration, convertible into 5 shares of the issuer's Common Stock on this date upon, which is the date the issuer's shareholders approved the conversion of the Series B Convertible Preferred Stock. Includes (a) 16,288 shares of Common Stock held by Gregory Pusey IRA, (b) 6,500 shares of Common Stock issuable upon exercise of warrants, whether or not presently exercisable, held by Gregory Pusey IRA, (c) 73,044 shares of Common Stock underlying options to purchase Common Stock, whether or not presently exercisable, and (d) 15,000 shares of Common Stock issuable upon conversion of shares of Series B Convertible Preferred Stock, whether or not presently convertible, and (f) 120,750 shares held jointly by Reporting Person and Reporting Person's spouse. Includes (a) 16,288 shares of Common Stock held by Gregory Pusey IRA, (b) 6,500 shares of Common Stock issuable upon exercise of warrants, whether or not presently exercisable, held by Gregory Pusey IRA, (c) 73,044 shares of Common Stock underlying options to purchase Common Stock, whether or not presently exercisable, and (d) 15,000 shares of Common Stock issuable upon conversion of shares of Series B Convertible Preferred Stock, whether or not presently convertible, and (f) 160,750 shares held jointly by Reporting Person and Reporting Person's spouse. /s/ Jill Pusey as attorney-in-fact 2008-12-23 -----END PRIVACY-ENHANCED MESSAGE-----