SEC Form 5 · accession 0001511164-15-000001
PERPETUAL INDUSTRIES INC. · PRPI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Brent W. Bedford
Officer — Chairman, President, CEO · Director · 10% Owner
Period of report
Jul 31, 2014
Accepted (ET)
Jan 2, 2015 · 1:56 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001395445
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Apr 20, 2005 | A | 11,000,000 | $0.001 | A | 11,000,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Stock Option | $0.30 | Sep 30, 2014 | A | 1,000,000 | A | Sep 30, 2014 | Sep 30, 2019 | Common Stock | 1,000,000 | 1,000,000 | D |
| NoteF2,F1 | $0.30 | Sep 30, 2014 | A | 1,097,000 | A | Sep 30, 2014 | Sep 30, 2024 | Common Stock | 1,097,000 | 1,097,000 | D |
Explanation of responses
- F1No actual expiration date. 09/30/2024 was entered to satisfy the system requirement.
- F2Plus interest convertible at $0.30, accruing at 8% annually.