0001415889-13-000637.txt : 20130403
0001415889-13-000637.hdr.sgml : 20130403
20130403195517
ACCESSION NUMBER: 0001415889-13-000637
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20130402
FILED AS OF DATE: 20130403
DATE AS OF CHANGE: 20130403
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: FIELDS RANDALL K
CENTRAL INDEX KEY: 0001143335
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34941
FILM NUMBER: 13741347
MAIL ADDRESS:
STREET 1: 3160 PINEBROOK ROAD
CITY: PARK CITY
STATE: UT
ZIP: 84098
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PARK CITY GROUP INC
CENTRAL INDEX KEY: 0000050471
STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374]
IRS NUMBER: 371454128
STATE OF INCORPORATION: NV
FISCAL YEAR END: 0630
BUSINESS ADDRESS:
STREET 1: 299 S. MAIN STREET
STREET 2: SUITE 2370
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84111
BUSINESS PHONE: 435-645-2100
MAIL ADDRESS:
STREET 1: 299 S. MAIN STREET
STREET 2: SUITE 2370
CITY: SALT LAKE CITY
STATE: UT
ZIP: 84111
FORMER COMPANY:
FORMER CONFORMED NAME: FIELDS TECHNOLOGIES INC
DATE OF NAME CHANGE: 20010626
FORMER COMPANY:
FORMER CONFORMED NAME: AMERINET GROUP COM INC
DATE OF NAME CHANGE: 19990803
FORMER COMPANY:
FORMER CONFORMED NAME: EQUITY GROWTH SYSTEMS INC /DE/
DATE OF NAME CHANGE: 19951214
4
1
form4-04032013_110408.xml
X0306
4
2013-04-02
0000050471
PARK CITY GROUP INC
PCYG
0001143335
FIELDS RANDALL K
299 SOUTH MAIN STREET
SUITE 2370
SALT LAKE CITY
UT
84111
true
false
false
false
Common Stock
2013-04-02
4
C
0
24257
3
A
3990549
D
Series A Convertible Preferred Stock
3
2013-04-02
4
C
0
7277
D
Common Stock
24257
0
D
Series B Convertible Preferred Stock
10
2010-06-30
Common Stock
874065
349626
I
By Riverview Financial Corp
Series B Convertible Preferred Stock
10
2010-06-30
Common Stock
25000
10000
I
By Spouse
Warrant
3.60
2013-03-14
2018-03-14
Common Stock
6875
6875
D
The Reporting Person disposed of shares of Series A Convertible Preferred Stock ("Series A Preferred") as reported in Table II, and acquired shares of Common Stock reported in Table I pursuant to conversion rights under the Certificate of Designation of the Relative Rights, Powers and Preference of the Series A Preferred (the "Certificate of Designation").
Each share of Series A Preferred is convertible in that number of shares of Issuer's Common Stock determined by dividing the Series A Original Issue Price, as defined in the Certificate of Designation as $10.00 per Share, by $3.00.
Includes 175 shares of Series A Preferred issued to the Reporting Person as consideration for accumulated Series A Preferred dividends as of April 2, 2013.
The Series A Preferred are exercisable upon issuance.
The Series A Preferred remains convertible so long as the shares remain issued and outstanding.
Series B Convertible Preferred Stock remains convertible so long as the shares remain issued and outstanding.
/s/ Randall K. Fields
2013-04-03