-----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, N9AkaDM3blgFkpMde3G/M8P0aEXH810CX3rufYvNTvQh7c8/AtXtD+bLA6T7g1ZQ aFA/GK+e/eGrmlgzEA+9hA== 0001144204-04-016736.txt : 20041022 0001144204-04-016736.hdr.sgml : 20041022 20041022153601 ACCESSION NUMBER: 0001144204-04-016736 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040924 FILED AS OF DATE: 20041022 DATE AS OF CHANGE: 20041022 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: QT 5 INC CENTRAL INDEX KEY: 0000932127 STANDARD INDUSTRIAL CLASSIFICATION: PHARMACEUTICAL PREPARATIONS [2834] IRS NUMBER: 721148906 STATE OF INCORPORATION: DE FISCAL YEAR END: 0603 BUSINESS ADDRESS: STREET 1: 5655 LINDERO CANYON ROAD STREET 2: SUITE 120 CITY: WESTLAKE VILLAGE STATE: CA ZIP: 91362 BUSINESS PHONE: (866) 508-8378 MAIL ADDRESS: STREET 1: 5655 LINDERO CANYON ROAD STREET 2: SUITE 120 CITY: WESTLAKE VILLAGE STATE: CA ZIP: 91362 FORMER COMPANY: FORMER CONFORMED NAME: MONEYZONE COM DATE OF NAME CHANGE: 20000120 FORMER COMPANY: FORMER CONFORMED NAME: EBONLINEINC COM DATE OF NAME CHANGE: 19990715 FORMER COMPANY: FORMER CONFORMED NAME: CERX VENTURE CORP DATE OF NAME CHANGE: 19981116 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: OWENS TIMOTHY J CENTRAL INDEX KEY: 0001213618 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-25022 FILM NUMBER: 041091868 BUSINESS ADDRESS: STREET 1: 5655 LINDERO CANYON ROAD STREET 2: SUITE 120 CITY: WESTLAKE VILLAGE STATE: CA ZIP: 91360 BUSINESS PHONE: 8183381517 MAIL ADDRESS: STREET 1: 5655 LINDERO CANYON ROAD STREET 2: SUITE 120 CITY: WESTLAKE VILLAGE STATE: CA ZIP: 91360 4 1 v07724_ex.xml X0202 4 2004-09-24 0 0000932127 QT 5 INC QTFI 0001213618 OWENS TIMOTHY J C/O QT 5, INC. 5655 LINDERO CANYON ROAD SUITE 106 WESTLAKE VILLAGE CA 91362 0 1 1 0 Chief Executive Officer Common Stock 2004-09-24 4 J 0 100000000 A 127606049 D Warrant 1.70 2003-06-09 4 J 0 128000 0 A 2003-06-10 2008-06-09 Common Stock 128000 0 D Issued in lieu of $50,000 payment against Note Payable Warrants issued pursuant to an Employment Agreement entered into by to Reporting Person to act as Chief Executive Officer of the Issuer /s/ Timothy J. Owens 2004-10-22 -----END PRIVACY-ENHANCED MESSAGE-----