SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
HAZINE CHERMON CHERY

(Last) (First) (Middle)
C/O 132 NE 57 ST

(Street)
MIAMI FL 33137

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
ESTATE OF HAZINE CHERMON CHERY [ 52,115,796 ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director 10% Owner
X Officer (give title below) Other (specify below)
AGENT
3. Date of Earliest Transaction (Month/Day/Year)
07/01/2019
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
FL ADR No. 109-1982-071805 07/01/2019 07/01/2019 J(1) 150,000 D $150,000 99,790,000 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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Ipn (UNCITRAL) No. 0132463284-SALWR2REXKA818996-84532X(2) $150,000 07/01/2019 07/01/2019 J(3) 150,000 07/01/2019 03/02/2020 FL ADR No. 109-1982-071805 99,790,000 $150,000 150,000 I PRESTIGE IMPORTS, INC(4)
Explanation of Responses:
1. Commercial Substance was given to Derivative Security by way of Non Derivative Security. Please review Derivative Security Description and Remarks regarding said transaction.
2. International promissory note (UNCITRAL) No. 0132463284-SALWR2REXKA818996-84532X
3. International promissory note (UNCITRAL) No. 0132463284-SALWR2REXKA818996-84532X (Amount: $150,000.00) regarding acquired Prestige Imports miscellaneous documents by way of Form 1099A which was deposited as an asset with Prestige Imports, (Debit) for value received per 12 US Code 1813(L)(1) - Deposit (money or its equivalent); hence, Credit (Liability is transferred to the receiver of said asset) is due to said depositor per 1831n (a)(2)(A) - Uniform accounting principles consistent with G.A.A.P.. Form 1099 OID was filed regarding said instrument.
4. International promissory note (UNCITRAL) No. 0132463284-SALWR2REXKA818996-84532X (Amount: $150,000.00) regarding acquired Prestige Imports miscellaneous documents by way of Form 1099A which was deposited as an asset with Prestige Imports, (Debit) for value received per 12 US Code 1813(L)(1) - Deposit (money or its equivalent).
Remarks:
International promissory note was accompanied by SF 28 Affidavit of Individual Surety regarding pledged assets to or for the account of the United States. The Pledged assets are as followed: International promissory note (UNCITRAL) No. 0132463284-SALWR2REXKA818996-84532X, Copy of Certificate of Indebtedness No. 109 1982 071805 (18 US Code 8), SF 1416 Payment Bond For Other than Construction Contracts, and SF 1418 Performance Bond For Other than Construction Contracts. OF 90 Release of Lien on Real Property and OF 91 Release of Real Property from Escrow, were also included regarding said packet. All originals were deposited with said receiver, with the exception of Original Forms 1099s (which copies of Form 1099s was issued to Prestige Imports, Inc) which was submitted to the Department of the Treasury-Internal Revenue Service Center Austin, TX 73301. Same packet along with a particular information return form was also submitted to the Department of the Treasury-Internal Revenue Service Ogden, UT 84201. The purpose for submission is to protect the interest of the United States by conducting a proper tax assessment in order to prevent tax avoidance, initiate Tax Liabilities, prevent omission and theft of said negotiable instrument regarding said transaction in association with Prestige Imports, Inc.
HAZINE C CHERY CAF# 0312-58277R 07/08/2019
** 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.
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