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