0001299967-13-000021.txt : 20130318 0001299967-13-000021.hdr.sgml : 20130318 20130318190842 ACCESSION NUMBER: 0001299967-13-000021 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20130312 FILED AS OF DATE: 20130318 DATE AS OF CHANGE: 20130318 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Cerkovnik Edward CENTRAL INDEX KEY: 0001556567 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-32438 FILM NUMBER: 13699467 MAIL ADDRESS: STREET 1: 600 N. BRAND BLVD. STREET 2: SUITE 230 CITY: GLENDALE STATE: CA ZIP: 91203 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: MediaShift, Inc. CENTRAL INDEX KEY: 0001299967 STANDARD INDUSTRIAL CLASSIFICATION: CRUDE PETROLEUM & NATURAL GAS [1311] IRS NUMBER: 201373949 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 600 NORTH BRAND BLVD., SUITE 230 CITY: GLENDALE STATE: CA ZIP: 91203 BUSINESS PHONE: (818) 649-5710 MAIL ADDRESS: STREET 1: 600 NORTH BRAND BLVD., SUITE 230 CITY: GLENDALE STATE: CA ZIP: 91203 FORMER COMPANY: FORMER CONFORMED NAME: JMG Exploration, Inc. DATE OF NAME CHANGE: 20040806 4 1 primary_doc.xml PRIMARY DOCUMENT X0306 4 2013-03-12 0 0001299967 MediaShift, Inc. JMGED 0001556567 Cerkovnik Edward 600 N. BRAND BLVD. SUITE 230 GLENDALE CA 91203 1 0 0 0 Common Stock 2013-03-12 4 M 0 10000 A 10000 D Stock Option 1.14 2013-03-12 4 C 0 50000 A 2012-08-31 2018-08-31 Common Stock 50000 50000 D Note 3 2013-03-06 Common Stock 10000 10000 D Warrants 4 2013-03-06 2013-07-31 Common Stock 5000 5000 D Warrants 6 2013-03-06 2014-07-31 Common Stock 5000 10000 D Automatic cashless conversion of Class M Preferred Stock. Stock option exercisable into Class M Preferred Stock automatically converted into stock option exercisable into Common Stock. Maturity date of this note is 2/15/2015. /s/ Edward Cerkovnik 2013-03-18