| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 12/30/2011 |
3. Issuer Name and Ticker or Trading Symbol
LENCO MOBILE INC. [ LNCM ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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| Table I - Non-Derivative Securities Beneficially Owned | |||
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| 1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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| 1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
| Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
| Stock Option (Right to Buy)(1) | (2) | 01/17/2021 | Common Stock | 90,876 | $0.15 | D | |
| Stock Option (Right to Buy)(1) | (3) | 08/11/2019 | Common Stock | 200,000 | $0.15 | D | |
| Stock Option (Right to Buy)(1) | (3) | 03/20/2018 | Common Stock | 356 | $5.71 | D | |
| Stock Option (Right to Buy)(1) | (3) | 11/28/2017 | Common Stock | 9,124 | $5.71 | D | |
| Explanation of Responses: |
| 1. Represents an option assumed by the issuer in connection with acquisition of iLoop Mobile, Inc. ("iLoop") pursuant to an Amended and Restated Agreement and Plan of Merger among iLoop, the issuer and its subsidiary, and the stockholders representative (the "Merger Agreement"); the Merger Agreement is filed as Exhibit 2.1 to the issuer's Report on Form 8-K filed with the SEC on December 30, 2011. |
| 2. Option vested with respect to 25% of the shares on the one-year anniversary of the grant date (January 20, 2011); balance of option vests in equal monthly increments over the following three years. |
| 3. The option is fully vested and exercisable. |
| /s/ Richard E. Ballard | 04/23/2013 | |
| ** 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 5 (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 Number. | ||