SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

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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OMB Number: 3235-0362
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hours per response: 1.0
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
X
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
Christian Quilliam

(Last) (First) (Middle)
2520 MANATEE AVENUE WEST #200

(Street)
BRADENTON FL 34205

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
Silver Falcon Mining, Inc. [ SFMI ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
COO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2012
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
CLASS 'A' COMMON STOCK 12/11/2012 S4 10,000 D $0.018 37,313,878 D
CLASS 'A' COMMON STOCK 12/14/2012 S4 25,000 D $0.019 37,288,878 D
CLASS 'A' COMMON STOCK 12/17/2012 S4 25,000 D $0.022 37,263,878 D
CLASS 'A' COMMON STCK 12/17/2012 S4 25,000 D $0.026 37,238,878 D
CLASS 'A' COMMON STCK 12/17/2012 S4 25,000 D $0.024 37,213,878 D
CLASS 'A' COMMON STOCK 12/19/2012 S4 25,000 D $0.024 37,188,878 D
CLASS 'A' COMMON STOCK 12/19/2012 S4 25,000 D $0.022 37,163,878 D
CLASS 'A' COMON STOCK 12/26/2012 S4 25,000 D $0.021 37,138,878 D
CLASS 'A' COMMON STOCK 12/28/2012 S4 25,000 D $0.022 37,113,878 D
CLASS 'A' COMMON STOCK 12/09/2012 A4 5,250,000(1) A $0.015 42,363,878 D
CLASS 'A' COMMON STOCK 12/09/2012 A4 2,655,533(1) A $0.015 45,019,411 D
CLASS 'B' COMMON STOCK 11/17/2012 A4 1,500,000(1) A $0.024 3,246,875 D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
STOCK OPTION $0.017 12/10/2012 4A 10,000,000(2) 12/10/2012 12/10/2022 COMMON STOCK 10,000,000 $0 23,000,000 D
Explanation of Responses:
1. RULE 144
2. OPTIONS NOT REGISTERED
/s/Christisn Qulliam 01/25/2012
** 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 4 (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.