-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, NTrRN/bLQ6kBv8tdDlrJ5aXEKwXoAEK85zFU7va8U+coKqK24nLxr2FxWdMxNffa J5fQlmRUKz3VQhX6WuSNdg== 0000950134-05-011810.txt : 20050611 0000950134-05-011810.hdr.sgml : 20050611 20050610170503 ACCESSION NUMBER: 0000950134-05-011810 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20050610 DATE AS OF CHANGE: 20050610 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: HAUSER PETER L CENTRAL INDEX KEY: 0001087019 FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: BUSINESS PHONE: 6125432821 MAIL ADDRESS: STREET 1: 16913 KINGS COURT CITY: LAKEVILLE STATE: MN ZIP: 55044 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MEDICALCV INC CENTRAL INDEX KEY: 0001144284 STANDARD INDUSTRIAL CLASSIFICATION: SURGICAL & MEDICAL INSTRUMENTS & APPARATUS [3841] IRS NUMBER: 411717208 STATE OF INCORPORATION: MN FISCAL YEAR END: 0430 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-62263 FILM NUMBER: 05890602 BUSINESS ADDRESS: STREET 1: 9725 SOUTH ROBERT TRAIL CITY: INVER GROVE HEIGHTS STATE: MN ZIP: 55077 BUSINESS PHONE: 6514523000 MAIL ADDRESS: STREET 1: 9725 SOUTH ROBERT TRAIL CITY: INVER GROVE HEIGHTS STATE: MN ZIP: 55077 SC 13G/A 1 c95952a3sc13gza.htm AMENDMENT TO SCHEDULE 13G sc13gza
 

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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION

Washington, D.C. 20549

SCHEDULE 13G

Under the Securities Exchange Act of 1934
(Amendment No. 3)(1)

MedicalCV, Inc


(Name of Issuer)

Common Stock


(Title of Class of Securities)

584639 10 8


(CUSIP Number)

June 10, 2005


(Date of Event Which Requires Filing of this Statement)

Check the appropriate box to designate the rule pursuant to which this Schedule is filed:

        o Rule 13d-1 (b)

        þ Rule 13d-1 (c)

        o Rule 13d-1 (d)

(1)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 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 Pages


 

             
13G
CUSIP No. 584639 10 8

  1. Name of Reporting Person:
Peter L. Hauser
I.R.S. Identification Nos. of above persons (entities only):

  2. Check the Appropriate Box if a Member of a Group:
    (a) o  
    (b) o  

  3. SEC Use Only:

  4. Citizenship or Place of Organization:
United States

Number of
Shares
Beneficially
Owned by
Each Reporting
Person With
5. Sole Voting Power:
1,166,924

6. Shared Voting Power:
None

7. Sole Dispositive Power:
1,166,924

8.Shared Dispositive Power:
None

  9.Aggregate Amount Beneficially Owned by Each Reporting Person:
1,166,924

  10.Check if the Aggregate Amount in Row (9) Excludes Certain Shares:
o

  11.Percent of Class Represented by Amount in Row (9):
9.999

  12.Type of Reporting Person:
IN


    Represents (a) 53,000 shares of common stock, (b) 908,328 shares of common stock purchasable upon the exercise of warrants, and (c) 180,600 shares of common stock held by the reporting person’s IRA. Does not include (a) 2,016,000 shares of common stock the reporting person may acquire upon the conversion of 1,008 shares of 540 Series A convertible preferred stock into common stock, or (b) 1,512,000 shares of common stock the reporting person may purchase upon the exercise of a warrant, except for an aggregate of 24,996 shares which the reporting person may acquire upon conversion of such preferred stock or exercise of such warrant, or a combination of both, as neither the conversion right or purchase right may be exercised so long as the reporting person beneficially owns 9.999% or more of the issuer’s common stock.

Page 2 of 5 Pages


 


     
ITEM I (a)
  NAME OF ISSUER:

MedicalCV, Inc.

     
ITEM I (b)
  ADDRESS OF ISSUER’S PRINCIPAL EXECUTIVE OFFICES:

9725 South Robert Trail
Inver Grove Heights, Minnesota 55077

     
ITEM 2 (a)
  NAME OF PERSON FILING

Peter L. Hauser

     
ITEM 2 (b)
  ADDRESS OF PRINCIPAL BUSINESS OFFICE OR, IF NONE, RESIDENCE.

16913 Kings Court
Lakeville, Minnesota 55044

     
ITEM 2 (c)
  CITIZENSHIP

United States

     
ITEM 2 (d)
  TITLE OF CLASS OF SECURITIES

Common Stock, $0.01 par value

     
ITEM 2 (e)
  CUSIP NUMBER.

584639 10 8

     
ITEM 3
  IF THIS STATEMENT IS FILED PURSUANT TO RULE 13D-I(B), OR 13D-2(B OR (C), CHECK WHETHER THE PERSON FILING IS A:

Not applicable

     
ITEM 4
  OWNERSHIP

Page 3 of 5 Pages

 


 

Provide the following information regarding the aggregate number and percentage of the class of securities of the issuer identified in Item 1.

                 
(a)
  Amount     1,166,924  
(b)
  Percent of class:     9.999%  
(c)
  Number of shares as to which such person has:
  (i)   Sole power to vote or direct the vote     1,166,924  
  (ii)   Shared power to vote or to direct the vote   None  
  (iii)   Sole power to dispose or to direct the disposition of     1,166,924  
  (iv)   Shared power to dispose or to direct the disposition of   None  
     
ITEM 5
  OWNERSHIP OF FIVE PERCENT OR LESS OF A CLASS.

If this statement is being filed to report the fact that as of the date hereof the reporting person has ceased to be the beneficial owner of more than five percent of the class of securities, check the following o.


     
ITEM 6
  OWNERSHIP OF MORE THAN FIVE 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 OR CONTROL PERSON.
 
   
  Not applicable
 
   
ITEM 8
  IDENTIFICATION AND CLASSIFICATION OF MEMBERS OF THE GROUP.
 
   
  Not applicable
 
   
ITEM 9
  NOTICE OF DISSOLUTION OF GROUP.
 
   
  Not applicable

Page 4 of 5 Pages

 


 

     
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 purpose 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 the purpose or effect.

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.

     
 
  June 10, 2005
   
 
  (Date)
 
   
 
  /s/ Peter L. Hauser
   
 
  (Signature)
 
   
 
  Peter L. Hauser
   
  (Name/Tile)


Page 5 of 5 Pages

 

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