-----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, EalUv8kBfeyeDNg0K/bMV4MYsUXriwVzmY6+4VEWDloYsfqhJZykVJMSzX5dcBlJ n2WeXjUEAMTHpIxOJXcvRw== 0001110726-01-500007.txt : 20010530 0001110726-01-500007.hdr.sgml : 20010530 ACCESSION NUMBER: 0001110726-01-500007 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20001231 FILED AS OF DATE: 20010529 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PROVIDENCE CAPITAL VII INC CENTRAL INDEX KEY: 0001110726 STANDARD INDUSTRIAL CLASSIFICATION: [9995] IRS NUMBER: 050508623 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: SEC FILE NUMBER: 000-30437 FILM NUMBER: 1649357 BUSINESS ADDRESS: STREET 1: 735 BROAD STREET, SUITE 800 STREET 2: SUITE 800 CITY: CHATTANOOGA STATE: TN ZIP: 37402 BUSINESS PHONE: 423-265-50 MAIL ADDRESS: STREET 1: 735 BROAD STREET STREET 2: SUITE 800 CITY: CHATTANOOGA STATE: TN ZIP: 37402 COMPANY DATA: COMPANY CONFORMED NAME: PROVIDENCE CAPITAL VII INC CENTRAL INDEX KEY: 0001110726 STANDARD INDUSTRIAL CLASSIFICATION: [9995] OWNER IRS NUMBER: 050508623 STATE OF INCORPORATION: CO FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 BUSINESS ADDRESS: STREET 1: 735 BROAD STREET, SUITE 800 STREET 2: SUITE 800 CITY: CHATTANOOGA STATE: TN ZIP: 37402 BUSINESS PHONE: 423-265-50 MAIL ADDRESS: STREET 1: 735 BROAD STREET STREET 2: SUITE 800 CITY: CHATTANOOGA STATE: TN ZIP: 37402 5 1 mt552901.txt FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION WASHINGTON, D.C. 20549 FORM 5 ANNUAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 1. Name and Address of Reporting Person Mark T. Thatcher c\o Nadeau & Simmons, P.C. 1250 Turks Head Building Providence, RI 02903 2. Issuer Name and Ticker or Trading Symbol Providence Capital VII, Inc. Ticker or Trading Symbol: N/A 3. IRS or Social Security Number of Reporting Person (Voluntary) N/A 4. Statement for Month/Year 2000 5. If Amendment, Date of Original (Month/Year) N/A 6. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director (X) 10% Owner (X) Officer (give title below) ( ) Other (specify below) Secretary 7. Individual or Joint/Group Filing (Check Applicable Line) (X) Form filed by One Reporting Person ( ) Form filed by More than One Reporting Person
__________________________________________________________________________________________________________________________________ Table I -- Non-Derivative Securities Beneficially Owned __________________________________________________________________________________________________________________________________ 1. Title of Security |2. |3. |4.Securities Acquired (A) |5.Amount of | |7.Nature of Indirect | Transaction | or Disposed of (D) | Securities |6.Dir | Beneficial Ownership | | | | Beneficially |ect | | | | | | | | Owned |(D)or | | | | | | A/| | |Indir | | Date |Code|V| Amount | D | Price | |ect(I)| __________________________________________________________________________________________________________________________________ COMMON STOCK (voting) |11/24/|A | | 100,000 |A | $0.0038| 100,000 |D |N/A 1999 | | | | | | | | COMMON STOCK (voting) 6/15/ D 100,000 D N/A 0 N/A N/A 2000 COMMON STOCK (voting) 6/15/ A 250,000 A N/A 250,000 D N/A 2000 - ---------------------------------------------------------------------------------------------------------------------------------- __________________________________________________________________________________________________________________________________ __________________________________________________________________________________________________________________________________ Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned ___________________________________________________________________________________________________________________________________| 1.Title of Derivative |2.Con- |3. |4. |5.Number of De |6.Date Exer|7.Title and Amount |8.Price|9.Number |10.|11.Nature of Security |version |Transaction | rivative Secu |cisable and| of Underlying |of Deri|ofDeriva |Dir|Indirect |or Exer | | | rities Acqui |Expiration | Securities |vative |tive |ect|Beneficial |cise | | | red(A) or Dis |Date(Month/| |Secu |Securities |(D)|Ownership |Price of| | | posed of(D) |Day/Year) | |rity |Benefi |or | |Deriva- | | | |Date |Expir| | |ficially |Ind| |tive | | | | A/|Exer-|ation| Title and Number | |Owned at |ire| |Secu- | | | | | D |cisa-|Date | of Shares | |End of |ct | |rity |Date |Code|V| Amount | |ble | | | |Year |(I)| ___________________________________________________________________________________________________________________________________ - ----------------------------- SIGNATURE OF REPORTING PERSON /s/ Mark T. Thatcher MARK T. THATCHER DATE May 29, 2001 -----END PRIVACY-ENHANCED MESSAGE-----