0001108890-05-000079.txt : 20120705
0001108890-05-000079.hdr.sgml : 20120704
20050207161933
ACCESSION NUMBER: 0001108890-05-000079
CONFORMED SUBMISSION TYPE: SC 13G/A
PUBLIC DOCUMENT COUNT: 1
FILED AS OF DATE: 20050207
DATE AS OF CHANGE: 20050207
SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: MEDIA SCIENCES INTERNATIONAL INC
CENTRAL INDEX KEY: 0001024022
STANDARD INDUSTRIAL CLASSIFICATION: MISCELLANEOUS CHEMICAL PRODUCTS [2890]
IRS NUMBER: 840475073
STATE OF INCORPORATION: DE
FISCAL YEAR END: 0630
FILING VALUES:
FORM TYPE: SC 13G/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 005-54247
FILM NUMBER: 05580722
BUSINESS ADDRESS:
STREET 1: 40 BOROLINE ROAD
CITY: ALLENDALE
STATE: NJ
ZIP: 07401
BUSINESS PHONE: 2012361100
MAIL ADDRESS:
STREET 1: 40 BOROLINE ROAD
CITY: ALLENDALE
STATE: NJ
ZIP: 07401
FORMER COMPANY:
FORMER CONFORMED NAME: CADAPULT GRAPHIC SYSTEMS INC
DATE OF NAME CHANGE: 19980902
FORMER COMPANY:
FORMER CONFORMED NAME: SEAFOODS PLUS LTD
DATE OF NAME CHANGE: 19961002
FILED BY:
COMPANY DATA:
COMPANY CONFORMED NAME: BERTHEL SBIC LLC
CENTRAL INDEX KEY: 0001047557
IRS NUMBER: 522040126
STATE OF INCORPORATION: DE
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: SC 13G/A
BUSINESS ADDRESS:
STREET 1: 701 TAMA ST
STREET 2: BLDG B
CITY: MARION
STATE: IA
ZIP: 52302
BUSINESS PHONE: 3193652506
MAIL ADDRESS:
STREET 1: 100 SECOND STREET S.E.
CITY: CEDAR RAPIDS
STATE: IA
ZIP: 52401
SC 13G/A
1
berthel13ga3-020705.txt
DATED 02-07-05
SCHEDULE 13G
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
Under the Securities Exchange Act of 1934
(Amendment No. 3)
MEDIA SCIENCES INTERNATIONAL, INC.
f/k/a Cadapult Graphic Systems, Inc.
--------------
(Name of Issuer)
COMMON STOCK, PAR VALUE $.001 PER SHARE
----------------------------
(Title of Class of Securities)
58446x 10 7
------------
(CUSIP Number)
October 1, 2004
-----------------------------------------------------
(Date of Event Which Requires Filing of this Statement)
Check the appropriate box to designate the rule pursuant to which this Schedule
is filed:
[ ] Rule 13d-1(b)
[ x ] Rule 13d-1(c) (amendment)
[ ] Rule 13d-1(d)
*The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which would
alter the disclosures provided in a prior cover page.
The information required in the remainder of this cover page shall not be
deemed to be "filed" for the purpose of Section 18 of the Securities Exchange
Act of 1934 ("Act") or otherwise subject to the liabilities of that section of
the Act but shall be subject to all other provisions of the Act (however, see
the Notes).
Page 1 of 5
CUSIP No.: 58446x 10 7
-----------
--------------------------------------------------------------------------------
1. Names of Reporting Persons S.S. or I.R.S. Identification Nos. of Above
Persons:
BERTHEL SBIC, LLC 52-2040126
--------------------------------------------------------------------------------
2. Check the Appropriate Box if a Member of a Group (See Instructions).:
(a) [ ]
(b) [ ]
--------------------------------------------------------------------------------
3. SEC Use Only
--------------------------------------------------------------------------------
4. Citizenship or Place of Organization: Delaware
--------------------------------------------------------------------------------
Number of 5. Sole Voting Power: 1,059,840 (1)
Shares --------------------------------------------------------
Beneficially 6. Shared Voting Power: 0
Owned by --------------------------------------------------------
Each 7. Sole Dispositive Power: 1,177,840
Reporting --------------------------------------------------------
Person 8. Shared Dispositive Power: 0
With --------------------------------------------------------
9. Aggregate Amount Beneficially Owned by Each Reporting Person: 1,177,840
--------------------------------------------------------------------------------
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares (See
Instructions):
Not Applicable
--------------------------------------------------------------------------------
11. Percent of Class Represented by Amount in Row 9: 11.71%
--------------------------------------------------------------------------------
12. Type of Reporting Person (See Instructions): IV
--------------------------------------------------------------------------------
Footnote (1): The reporting person owns warrants and options to acquire
118,000 shares of the common stock of the issuer
Page 2 of 5
Item 1 (a) Name of Issuer:
MEDIA SCIENCES INTERNATIONAL, INC. f/k/a Cadapult Graphic
Systems, Inc.
(b) Address of Issuer's Principal Executive Offices:
40 Boroline Road
Allendale, New Jersey 07401
Item 2 (a) Names of Persons Filing: Berthel SBIC, LLC
(b) Address or Principal Business Office or, if none, Residence:
701 Tama Street, Building B
Marion, Iowa 52302
(c) Citizenship: Organized under the laws of Delaware
(d) Title of Class of Securities: Common Stock, par value
$.001 per share
(e) CUSIP No.: 127206 10 0
Item 3. If this statement is filed pursuant to Rules 13d-1(b), or
13d-2(b), check whether the person filing is a:
(a) [ ] Broker or dealer registered under section 15 of the Act
(15 U.S.C.78o);
(b) [ ] Bank as defined in section 3(a)(6) of the Act
(15 U.S.C. 78c);
(c) [ ] Insurance company as defined in section 3(a)(19) of the
Act (15 U.S.C. 78c);
(d) [ ] Investment company registered under section 8 of the
Investment Company Act of 1940 (15 U.S.C. 80a-8).
(e) [ ] An investment adviser in accordance with ss. 240.13d-1
(b)(1)(ii)(E);
(f) [ ] An employee benefit plan or endowment fund in accordance
with ss. 240.13d-1(b)(1)(ii)(F);
Page 3 of 5
(g) [ ] A parent holding company or control person in accordance
with ss. 240.13d-1(b)(1)(ii)(G);
(h) [ ] A savings association as defined in Section 3(b) of the
Federal Deposit Insurance Act (12 U.S.C. 1813);
(i) [ ] A church plan that is excluded from the definition of an
investment company under section 3(c)(14) of the
Investment Company Act of 1940 (15 U.S.C. 80a-3);
(j) [ ] Group, in accordance with ss. 240.13d-1(b)(1)(ii)(J).
Item 4 (a) - (c). Ownership
The information in items 1 and 5-11 on the cover pages of this
statement on Schedule 13G is hereby incorporated by reference.
Item 5. Ownership of 5 Percent or Less of a Class. [ ] Not Applicable
Item 6. Ownership of More than 5 Percent on Behalf of Another Person:
Not Applicable.
Item 7. Identification and Classification of the Subsidiary Which
Acquired the Security Being Reported on By the Parent Holding
Company: Not Applicable.
Item 8. Identification and Classification of Members of the Group:
Not Applicable
Item 9. Notice of Dissolution of Group: Not Applicable
Item 10. Certification
By signing below I certify that, to the best of my knowledge and belief, the
securities referred to above were not acquired and are not held for the purposes
of or with the effect of changing or influencing the control of the issuer of
the securities and were not acquired and are not held in connection with or as a
participant in any transaction having that purpose or effect.
Page 4 of 5
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I certify
that the information set forth in this statement is true, complete and correct.
Date: February 7, 2005
BERTHEL SBIC, LLC
By: Berthel Fisher & Company
Planning, Inc., Manager
By: /s/ Thomas J. Berthel
-------------------------------
Thomas J. Berthel
President
Page 5 of 5