-----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, HtYA8Z5YSdoD4oCzAnFcnYmTnKQTKN1sBtZ4P51WJdUMl4cC7yEbMJnBZsH0ZAdQ 62uXjZPFp+VuCRrfT9X71Q== 0001209191-10-009132.txt : 20100216 0001209191-10-009132.hdr.sgml : 20100215 20100216090224 ACCESSION NUMBER: 0001209191-10-009132 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20091231 FILED AS OF DATE: 20100216 DATE AS OF CHANGE: 20100216 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: Diligent Board Member Services, Inc. CENTRAL INDEX KEY: 0001433269 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-PREPACKAGED SOFTWARE [7372] IRS NUMBER: 261189601 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 8TH FLOOR, 39 WEST 37TH STREET CITY: NEW YORK STATE: NY ZIP: 10018 BUSINESS PHONE: 973-299-1000 MAIL ADDRESS: STREET 1: 8TH FLOOR, 39 WEST 37TH STREET CITY: NEW YORK STATE: NY ZIP: 10018 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: Carroll Capital Holdings LLC CENTRAL INDEX KEY: 0001439496 STATE OF INCORPORATION: NJ FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-53205 FILM NUMBER: 10602583 BUSINESS ADDRESS: STREET 1: 94 LONG POND ROAD CITY: HEWITT STATE: NJ ZIP: 07421 BUSINESS PHONE: 201-819-5399 MAIL ADDRESS: STREET 1: 94 LONG POND ROAD CITY: HEWITT STATE: NJ ZIP: 07421 5 1 doc5.xml FORM 5 SUBMISSION X0303 5 2009-12-31 0 0 0 0001433269 Diligent Board Member Services, Inc. DIL.NZ 0001439496 Carroll Capital Holdings LLC 94 LONG POND ROAD HEWITT NJ 07421 0 0 1 0 Common Stock 2009-09-25 5 S 0 145644 0.14 D 0 I By Services Share Holdings, LLC Common Stock 2009-10-28 5 S 0 70457 0.30 D 0 I By Services Share Holdings, LLC Common Stock 2009-10-30 5 S 0 3288 0.29 D 0 I By Services Share Holdings, LLC Common Stock 6767925 D Common Stock 4881735 I By Services Share Holdings, LLC Series A Preferred Stock Common Stock 10889219 D Price in United States dollars. The issuer's common stock is traded in New Zealand dollars on the New Zealand Stock Exchange. The Shares represent the reporting person's interest in securities owned by Services Share Holdings, LLC ("SSH"). All such shares are subject to pledge. The reporting person is a member of SSH. SSH owns 20,786,097 shares of the issuer ("SSH Shares") of which shares 4,881,735 were contributed by the reporting person. Decisions with respect to how the SSH Shares are voted are made by holders of a majority of the SSH Shares. This filing shall not be deemed an admission that the reporting person is the beneficial owner of the SSH Shares. The Series A Preferred Stock is initially convertible into Common Stock on a one-for-one basis. Includes 889,219 shares issued to the reporting person on January 4, 2010 in lieu of a cash dividend in accordance with the issuer's Certificate of Designations. The reporting person did not have the choice of receiving cash in lieu of the PIK dividend. /s/ Kenneth Carroll, Manager /s/Kenneth Carroll 2010-02-10 -----END PRIVACY-ENHANCED MESSAGE-----