0001140361-11-036304.txt : 20110708
0001140361-11-036304.hdr.sgml : 20110708
20110708180629
ACCESSION NUMBER: 0001140361-11-036304
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110629
FILED AS OF DATE: 20110708
DATE AS OF CHANGE: 20110708
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Lazar Terry
CENTRAL INDEX KEY: 0001411926
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-09478
FILM NUMBER: 11960265
MAIL ADDRESS:
STREET 1: C/O WATER CHEF, INC.
STREET 2: 68 SOUTH SERVICE ROAD, SUITE 100
CITY: MELVILLE
STATE: NY
ZIP: 11747
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PureSafe Water Systems, Inc.
CENTRAL INDEX KEY: 0000764839
STANDARD INDUSTRIAL CLASSIFICATION: REFRIGERATION & SERVICE INDUSTRY MACHINERY [3580]
IRS NUMBER: 860515678
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 7707 EAST ACOMA DRIVE SUITE 109
CITY: SCOTTSDALE
STATE: AZ
ZIP: 85260
BUSINESS PHONE: 6029914534
MAIL ADDRESS:
STREET 1: 1007 GLEN COVE AVE.
CITY: GLEN HEAD
STATE: NY
ZIP: 11030
FORMER COMPANY:
FORMER CONFORMED NAME: WATER CHEF INC
DATE OF NAME CHANGE: 19930813
FORMER COMPANY:
FORMER CONFORMED NAME: AUTO SWAP USA INC
DATE OF NAME CHANGE: 19920703
FORMER COMPANY:
FORMER CONFORMED NAME: INTERMARK GAMING INTERNATIONAL INC/DE/
DATE OF NAME CHANGE: 19911106
4
1
doc1.xml
FORM 4
X0303
4
2011-06-29
0
0000764839
PureSafe Water Systems, Inc.
PSWS
0001411926
Lazar Terry
25 FAIRCHILD AVE
SUITE 250
PLAINVIEW
NY
11803
1
1
0
0
Chief Financial Officer
Common Stock
2011-06-29
4
P
0
10000
0.065
A
15290513
D
Common Stock
2011-06-30
4
P
0
5000
0.067
A
15295513
D
Common Stock
2011-07-07
4
A
0
189394
0.066
A
15484907
D
Common Stock
140000
I
See Footnote
In addition, Mr. Lazar owns beneficially 140,000 shares held by his wife's IRA.
/s/ Terry Lazar
2011-07-08