6-K 1 form6-k.txt FORM 6-K SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 Report of Foreign Private Issuer Pursuant to Rule 13a-16 or 15d-16 of the Securities Exchange Act of 1934 ------------------------------- For the month(s) of July , 2001 ---------------------------- BELMONT RESOURCES INC. ------------------------------------------------------------ (Translation of registrant's name into English) Suite 600 - 625 Howe Street, Vancouver, B.C. V6C 2T6 ------------------------------------------------------------ (Address of principal executive offices) [Indicate by a check mark whether the registrant files or will file annual reports under cover Form 20-F or Form 40-F. Form 20-F X Form 40-F ---------------- ---------------- [Indicate by a check mark whether the registrant by furnishing the information contained in this Form is also thereby furnishing the information to the Commission pursuant to Rule 12g3-2(b) under the Securities Exchange Act of 1934. Yes X No ---------------- --------------- [If "Yes" is marked, indicate below the file number assigned to the registrant in connection with Rule 12g3-2(b): 82-686. --- SIGNATURES Pursuant to the requirements of the Securities Exchange Act of 1934, the ------------------------------- registrant has duly caused this report to be signed on its behalf by the undersigned, thereunto duly authorized. Belmont Resources Inc. --------------------------------- (Registrant) Date August 2, 2001 By /s/ Gary Musil ------------------ ------------------------------- (Signature) Gary Musil, Secretary/Director BELMONT RESOURCES INC. ================================================================================ #600 - 625 Howe Street Vancouver, B.C. V6C 2T6 Ph: (604) 683-6648 Fax: (604) 683-1350 E-Mail: belmontr@direct.ca Website: www.Belmont-Resources.com June 25, 2001 Canadian Venture Exchange 4th Floor - 609 Granville Street Vancouver, BC V7Y 1H1 Attention: Corporate Finance Services -------------------------------------- Dear Sirs: Re: Stock Options ------------------ We request that the Canadian Venture Exchange approve the renegotiated price granting of 1,630,000 stock options to a price of $0.14 as announced in a news release issued by the Company on June 25, 2001. In support of this application, we enclose the following documents: 1. One Form 4K - Summary Form - Incentive Stock Options; 2. One Form 4L - Declaration of Incentive Stock Options; and 3. A cheque for $642.00 payable to the Canadian Venture Exchange for filing fees. If you have any questions regarding the abovementioned documents, please contact us at the above address. Yours truly, /s/ Gary Musil Gary Musil Secretary/Director Enclosures c.c. Martin & Associates, Solicitors Securities & Exchange Commission, Wash. D.C. USA FORM 4K SUMMARY FORM - INCENTIVE STOCK OPTIONS Re: Belmont Resources Inc. (the "Issuer") SEDAR Project #: _________________ 1. NEW OPTIONS PROPOSED FOR ACCEPTANCE Date of Grant: N/A -------------------
=================================================================================================================== Name of Position Insider? No. of Exercise Expiry No. of Options Optionee (Director/Senior Yes or Optioned Price Date Granted in the Officer/Employee/ No Shares Past 12 Months Consultant ------------------------------------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------------------------------------- None - - - - - - ===================================================================================================================
Total Number of optioned shares proposed for acceptance: N/A ----------- 2. AMENDED OPTIONS PROPOSED FOR ACCEPTANCE
=================================================================================================================== Name of Optionee No. of Optioned Amended Original Date of New/Current Shares Exercise Price Grant Date =================================================================================================================== Peter P. H. John 500,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Vojtech Agyagos 200,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Gary Musil 50,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Kenneth B. Liebscher 50,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Peter E. Serck 50,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Jake Bottay 50,000 $0.14 August 17, 2000 August 17, 2002 ------------------------------------------------------------------------------------------------------------------- Jake Bottay 75,000 $0.14 February 18, 2000 February 18, 2002 ------------------------------------------------------------------------------------------------------------------- Nimrod Investments Ltd. 200,000 $0.14 January 13, 2000 January 13, 2002 ------------------------------------------------------------------------------------------------------------------- Duster Capital Corp. 30,000 $0.14 January 13, 2000 January 13, 2002 ------------------------------------------------------------------------------------------------------------------- Vojtech Agyagos 75,000 $0.14 September 17, 1999 September 17, 2001 ------------------------------------------------------------------------------------------------------------------- Gary Musil 150,000 $0.14 September 17, 1999 September 17, 2001 ------------------------------------------------------------------------------------------------------------------- Peter Serck 100,000 $0.14 September 17, 1999 September 17, 2001 ------------------------------------------------------------------------------------------------------------------- Kenneth Liebscher 100,000 $0.14 September 17, 1999 September 17, 2001 ===================================================================================================================
3. OTHER PRESENTLY OUTSTANDING OPTIONS: (excluding those included in item 2 above)
============================================================================================= Name of Optionee No. of Optioned Exercise Original Date Expiry Date Shares Remaining Price or Grant --------------------------------------------------------------------------------------------- None - - - - =============================================================================================
Total Number of shares optioned, including those proposed for acceptance in 1 and/or 2 above: 1,630,000 ---------- 4. ADDITIONAL INFORMATION (a) If shareholder approval was required for the grant of options, state the date that the shareholder meeting approving the grant was or will be held. July 24, 2000 ------------- (b) If applicable, state the date of the news release announcing the grant of options: June 25, 2001 ------------- (c) State the total issued and outstanding share capital at the date of grant: 20,703,012 ---------- (d) State, as a percentage of the issued shares of the Issuer indicated in (c) above, the aggregate number of shares that are subject to incentive stock options, including new options, amended options and other presently outstanding options: 7.9% ---- (e) Tier 2 Issuer: If the new options are being granted pursuant to a stock option plan, state the number of remaining shares reserved for issuance under the plan Not applicable ------------------ (f) If the Issuer has completed a public distribution of its securities within 90 days of the date of the grant, state the per share price paid by the public investors: Not applicable ---------------------- (g) If the grant of options is not in complete accordance with Policy 4.4 - Director, Officer and Employee Stock Options, indicate where there are deviations, and explain why a waiver of Exchange policy is in the best interests of the Issuer and the investing public. Not applicable -------------- FORM 4L DECLARATION OF INCENTIVE STOCK OPTIONS Issuer: Belmont Resources Inc. (the "Issuer") ---------------------- SEDAR Project #:________________ This Declaration accompanies an application to the Exchange for acceptance for filing of Incentive Stock Options summarized in the Summary Form - Incentive Stock Options attached hereto (the "Filing"). The undersigned hereby certifies that: 1. The undersigned is a director and/or senior officer of the Issuer and has been duly authorized by a resolution of the board of directors of the Issuer to make this Declaration. 2. The Issuer is not an Inactive Company as defined in Policy 2.6 - Inactive Issuers and Reactivation. 3. The Filing is either in all respects in accordance with Exchange Policy 4.4 - Director, Officer and Employee Stock Options, in effect as of the date of this Declaration, or any deviations are indicated on the attached Summary Form 4. As of the date of grant there were no material changes in the affairs of the Issuer which were not been publicly disclosed. 5. The Issuer is not currently in default of its financial statement and fee filing requirements in the jurisdictions in which it is a reporting issuer. 6. The information on the attached Summary Form - Incentive Options is true. Dated this 25th day of June, 2001. ---- ---- Gary Musil --------------------------------- Name of Director and/or Senior Officer /s/ Gary Musil --------------------------------- Signature Secretary/Director --------------------------------- Official Capacity BELMONT RESOURCES INC. ================================================================================ #600 - 625 Howe Street Vancouver, B.C. V6C 2T6 Ph: (604) 683-6648 Fax: (604) 683-1350 E-Mail: belmontr@direct.ca Website: www.Belmont-Resources.com July 16, 2001 B.C. Securities Commission 9th Floor, 701 W. Georgia Street Vancouver, B.C. Attn: Statutory Filings --------------------------- Dear Sir or Madam: Re: Amended Form 20 ----------------------- Enclosed is our Amended Form 20 regarding the repricing of Incentive Stock Options announced on June 25, 2001. If you require any additional information, please contact us at the above address. Yours truly, /s/ Gary Musil Gary Musil, Secretary/Director Enclosures cc: Martin & Associates, Solicitors Securities & Exchange Commission, Wash. D.C., USA This is the form required under section 139 of the Securities Rules and, if applicable, by an order issued under section 76 of the Securities Act. AMENDED FORM 20 SECURITIES ACT Report of Exempt Distribution Report of a distribution under Section 74(2)(1) to (5), (8) to (10), 11(i), (14), (16)(i), (18), 19 or (23) to (26) of the Securities Act, R.S.B.C. 1996, c. 418 (the "Act"), or section 128(a), (b), (c) or (e) to (h) of the Securities Rules, R.B.C. Reg 194/97 (the "Rules"), or, if applicable, by an order issued under section 76 of the Act. 1. Name, address and telephone number of the issuer of the security distributed (the "Issuer"): Belmont Resources Inc. 600 - 625 Howe Street Vancouver, BC V6C 2T6 Telephone: (604) 683-6648 2. State whether the Issuer is or is not an exchange issuer (i.e. listed on the Vancouver Stock Exchange but not listed or quoted on any other stock exchange or trading or quotation system in Canada). The Issuer is an exchange issuer. 3. Describe the type of security and the aggregate number distributed: Incentive stock options to purchase a total of 1,630,000 common shares in the capital of the Issuer. The options are exercisable on various dates (see CDNX Letter attached) at the price of $0.14 per share. 4. Date of the distribution(s) of the Security: July 11, 2001 Page 2 5. Specify the section(s) of the Act or Rules and, if applicable, the date of the discretionary order or the blanket order number under which the distribution(s) of the security was made: Section 74(2)(9) of the Act 6. If the distribution(s) of the security was made to 50 purchasers or less, circle and complete clause (a) of this section. If the distribution(s) of the security was made to more than 50 purchasers, circle clause (b) of this item. (a) Full name and Residential Number of Securities Purchase Price Address of Purchasers Optioned Peter P.H. John 500,000 Nil Paseo de Zorilla 47006 Valladolid, Spain Vojtech Agyagos 275,000 Nil 1365 Dempsey Road North Vancouver, BC, V7K 1S7 Gary Musil 200,000 Nil 3577 Marshall Street Vancouver, BC, V5N 4S2 Kenneth B. Liebscher 150,000 Nil 3577B Marshall Street Vancouver, BC, V5N 4S2 Peter E. Serck 150,000 Nil 35 Thorncliffe Park Toronto, ON, M4H 1J3 Jake Bottay 125,000 Nil #603 - 2180 Argyle Avenue West Vancouver, BC, V7V 1A4 Nimrod Investments Ltd. 200,000 Nil #2 - 301 Afton Lane Port Moody, B.C. V3H 3V8 Duster Capital Corp. 30,000 Nil 201 - 1935 Haro Street Vancouver, BC, V6G 1H8 Page 3 (b) The Issuer has prepared and certified a list of purchasers comprising the same information required by clause (a) of this section and a certified true copy of the list will be provided to the Commission upon request. 7. State the total dollar value (Canadian $) of the securities distributed by the Issuer to purchasers resident in British Columbia in respect of which this report is filed. No proceeds have been derived in British Columbia by the Issuer from the distribution. 8. State the name and address of any person acting as agent in connection with the distribution(s) of the security, the compensation paid or to be paid to the agent, and the name(s) of the purchaser(s) in respect of which the compensation was paid or is to be paid. No person is acting as agent in connection with the distribution. No compensation has been or will be paid to an agent in connection with the distribution. 9. If the distribution of the security was made under section 128(a) of the Rules, state the number of different purchasers who acquired any securities of the Issuer under that section during the 12 month period preceding the distribution of this security. Not applicable 10. If the distribution of the security was under section 128(h) of the Rules, state: (a) the number of different purchasers who acquired securities of the Issuer under that exemption during the 12 month period preceding the distribution; and Not applicable (b) the total dollar value (Canadian $) of all securities of the Issuer distributed under that section (including the distribution of this security), during the 12 month period preceding the distribution of this security. Not applicable Page 4 The undersigned hereby certifies that the statements made in this report are true and correct. DATED at Vancouver, B.C. this 16th day of July, 2001. BELMONT RESOURCES INC. ---------------------------------- (Name of Issuer) per: /s/ Gary Musil ---------------------------------- Signature Secretary/Director ---------------------------------- Official Capacity - Please Print Gary Musil ---------------------------------- (Please print here name of individual whose signature appears above, if different from issuer or agent printed above.) IT IS AN OFFENCE FOR A PERSON TO MAKE A STATEMENT IN A RECORD REQUIRED TO BE FILED OR PROVIDED UNDER THE SECURITIES ACT OR SECURITIES RULES THAT, AT THE TIME AND IN THE LIGHT OF CIRCUMSTANCES UNDER WHICH IT IS MADE, IS A MISREPRESENTATION. BELMONT RESOURCES INC. ================================================================================ #600 - 625 Howe Street Vancouver, B.C. V6C 2T6 Ph: (604) 683-6648 Fax: (604) 683-1350 E-Mail: belmontr@direct.ca Website: www.Belmont-Resources.com July 17, 2001 SEDAR B.C. Securities Commission 9th Floor, 701 W. Georgia Street Vancouver, B.C. Attn: Statutory Filings --------------------------- Dear Sir or Madam: Re: Belmont Resources Inc. (the "Company") ---------------------------------------------- Attached herewith please find a Form 27 regarding a material change of July 17, 2001. Yours truly, /s/ GARY MUSIL Gary Musil, Secretary/Director GM/rm Enclosure c.c. - Alberta Securities Commission (SEDAR) - Securities & Exchange Commission, Washington, D.C., U.S.A. FORM 27 SECURITIES ACT MATERIAL CHANGE REPORT UNDER SECTION 67(1) OF THE ACT ITEM 1. REPORTING ISSUER Belmont Resources Inc. (the "Company") 600 - 625 Howe Street, Vancouver, BC V6C 2T6 ITEM 2. DATE OF MATERIAL CHANGE July 17, 2001 ITEM 3. PRESS RELEASE Issued July 17, 2001 and distributed through the facilities of Vancouver Stockwatch. ITEM 4. SUMMARY OF MATERIAL CHANGE Belmont holds AGM - Approval of Rozmin s.r.o. Slovakia ITEM 5. FULL DESCRIPTION OF MATERIAL CHANGE Belmont holds AGM - Approval of Rozmin s.r.o. Slovakia The Annual General Meeting of Belmont was held in Vancouver, B.C. on July 16, 2001. Six directors were re-elected including Vojtech Agyagos, Gary Musil, Kenneth B. Liebscher, Peter E. Serck, Peter John and Jake Bottay. The Special Resolution for the sale by Belmont of its 57% equity interest in Rozmin s.r.o. to EuroGas, Inc. on the terms and conditions described in the information circular was duly passed by the shareholders of the Company. All other resolutions proposed to the shareholders were also approved. ITEM 6. RELIANCE ON SECTION 67(2) OF THE ACT This report is not being filed on a confidential basis. ITEM 7. OMITTED INFORMATION There are no significant facts required to be disclosed herein which have been omitted. ITEM 8. DIRECTOR/SENIOR OFFICER Contact: Gary Musil, Secretary Telephone: (604) 683-6648 ITEM 9. STATEMENT OF SENIOR OFFICER/DIRECTOR The foregoing accurately discloses the material change referred to herein. /s/ GARY MUSIL Gary Musil, Secretary/Director DATED this 17th day of July, 2001.