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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 2270 (9-02) |
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 Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned at End of Issuer's Fiscal Year (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SHROTRIYA RAJESH C MD 11500 S. EASTERN AVE. SUITE 240 HENDERSON, NV 89052 |
 X |  X |  Chairman & CEO |  |
Kurt A. Gustafson, attorney-in-fact for Rajesh C. Shrotriya | 02/10/2017 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | This transaction involved a gift of securities by the reporting person to his three grandchildren who do not share the reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his three grandchildren and this report should not be deemed an admission that the reporting person is the beneficial owner of his grandchildren's shares for purposes of Section 16 or any other purpose. |
(2) | This transaction involved a gift of securities by the reporting person to his two adult children who do not share the reporting person's household. The reporting person disclaims beneficial ownership of the shares held by his adult children and this report should not be deemed an admission that the reporting person is the beneficial owner of his children's shares for purposes of Section 16 or any other purpose. |
(3) | This transaction involved a gift of securities by the Shrotriya Family Foundation, a Nevada nonprofit corporation, to a nonprofit charitable organization. The reporting person has an indirect beneficial ownership, as a director and officer of the Shrotriya Family Foundation, a Nevada nonprofit corporation. |
(4) | This transaction involved a transfer back to the reporting person from the Shrotriya Annuity Trust as a result of the termination of such Trust. |