SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person*
Reed Donald T

(Last) (First) (Middle)
2201 E. HICKORY HILL ROAD

(Street)
ARGYLE TX 76226

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
08/12/2011
3. Issuer Name and Ticker or Trading Symbol
OxySure Systems Inc [ N/A ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. 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 (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock 120,000 I Held by spouse
Common Stock 720,000 I Held by Agave Resources, LLC
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Warrants 04/15/2008 04/15/2013 Common Stock 350,000 0.01 I Held by Agave Resources, Inc.
Options 12/31/2006 12/31/2011 Common Stock 2,000 2 D
Options 12/31/2008 12/31/2013 Common Stock 5,000 2 D
Convertible Preferred Stock 01/31/2006 (1) Common Stock 1,220,000 0.82 I Held by Agave Resources, Inc.
Convertible Securities 04/15/2008 04/15/2012 Common Stock 500,000 1.5 I Held by Agave Resources, Inc.
Explanation of Responses:
1. The shares are convertible by the shareholder at anytime.
Don Reed 08/26/2011
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 5 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.