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Share Name | Share Symbol | Market | Type |
---|---|---|---|
Perpetual Inds Inc (PK) | USOTC:PRPI | OTCMarkets | Common Stock |
Price Change | % Change | Share Price | Bid Price | Offer Price | High Price | Low Price | Open Price | Shares Traded | Last Trade | |
---|---|---|---|---|---|---|---|---|---|---|
0.00 | 0.00% | 0.04 | 0.018 | 0.05 | 0.00 | 21:00:00 |
FORM 5
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
[ ] Form 3 Holdings Reported [ ] Form 4 Transactions Reported |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549 |
OMB APPROVAL
OMB Number: 3235-0362 Estimated average burden hours per response... 1.0 |
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1. Name and Address of Reporting Person * Bedford Brent W. | 2. Issuer Name and Ticker or Trading Symbol PERPETUAL INDUSTRIES INC. [PPII] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__ X __ Officer (give title below) _____ Other (specify below) Chairman, President, CEO |
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3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form Filed by One Reporting Person
___ Form Filed by More than One Reporting Person |
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned |
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1.Title of Security
(Instr. 3) |
2. Trans. Date | 2A. Deemed Execution Date, if any |
3. Trans. Code
(Instr. 8) |
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5) |
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4) |
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4) |
7. Nature of Indirect Beneficial Ownership
(Instr. 4) |
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Amount | (A) or (D) | Price | ||||||||
Common Stock | 4/20/2005 | 4/20/2005 | A | 11000000 | A | $0.001 | 11000000 | D |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned ( e.g. , puts, calls, warrants, options, convertible securities) |
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1. Title of Derivate Security
(Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Trans. Date | 3A. Deemed Execution Date, if any |
4. Trans. 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
(MM/DD/YYYY) |
7. Title and Amount of Securities Underlying Derivative Security
(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 | ||||||||||
Stock Option | $0.3 | 9/30/2014 | A | 1000000 | 9/30/2014 | 9/30/2019 | Common Stock | 1000000 | $0 | 1000000 | D | ||||
Note (2) | $0.3 | 9/30/2014 | A | 1097000 | 9/30/2014 | 9/30/2024 (1) | Common Stock | 1097000 | $0 | 1097000 | D |
Explanation of Responses: | |
( 1) | No actual expiration date. 09/30/2024 was entered to satisfy the system requirement. |
( 2) | Plus interest convertible at $0.30, accruing at 8% annually. |
Reporting Owners
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Reporting Owner Name / Address |
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Director | 10% Owner | Officer | Other | ||
Bedford Brent W.
5 - 8720 MACLEOD TRAIL SOUTH, #110 CALGARY, A0 T2H 0M4 |
X | X | Chairman, President, CEO |
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Signatures
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/s/ Brent Beford | 1/2/2015 | |
** Signature of Reporting Person | Date |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |
* | 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). |
Note: | File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. |
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. |
1 Year Perpetual Inds (PK) Chart |
1 Month Perpetual Inds (PK) Chart |
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