FORM 5 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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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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. | |||||||||||||||||
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Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
Heckmann CORP [ HEK ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Statement for Issuer's Fiscal Year Ended
(Month/Day/Year) 12/31/2009 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | |||||||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock Par Value $0.001 | 12,757,736(1) | I(2) | See footnotes. | ||||||||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 10,000(3) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 10,000(4) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 45,000(5) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(6) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(7) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(8) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(9) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(10) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(11) | D | $0.00 | 12,757,736 | I(2) | See Footnotes | |||||||
Common Stock Par Value $0.001 | 12/11/2009 | G4 | 2,000(12) | D | $0.00 | 12,757,736 | I(2) | See Footnotes |
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 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 Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | |||||||||
Warrants | $6 | 01/30/2009 | 05/29/2017 | common | 5,000,000 | 5,000,000 | D | |||||||
Warrants | $6 | 11/12/2011(13) | 11/12/2011 | common | 12,777,736 | 12,777,736 | I(14) | See Footnotes |
Explanation of Responses: |
1. Mr. Heckmann and his affiliate entities have not sold any shares of common stock or warrants since formation. |
2. Of these shares (i) 12,757,736 are directly owned by Heckmann Acquisition, LLC (ii) Messrs. Ezzell and Anderson each have an interest in 75,000 shares by virtue of their interest in Heckmann Acquisition, LLC, and (iii) 68,500 of these shares are directly held by Mr. Heckmann's spouse. |
3. Gift by Mr. Heckmann to The Phoenix Suns Charities. |
4. Gift by Mr. Heckmann to the UCLA Foundation. |
5. Gift by Mr. Heckmann to his wife, Wendy Hope Heckmann. |
6. Gift by Mr. Heckmann to Brock Heckmann. |
7. Gift by Mr. Heckmann to Scott Heckmann. |
8. Gift by Mr. Heckmann to Todd Heckmann. |
9. Gift by Mr. Heckmann to Tom Heckmann. |
10. Gift by Mr. Heckmann to Jessica Heckmann. |
11. Gift by Mr. Heckmann to Madison Heckmann. |
12. Gift by Mr. Heckmann to Mikeala Heckmann. |
13. The Warrants may not be exercised unless and until the last sale price of the Issuer's common stock on the New York Stock Exchange, or other national securities exchange on which the Issuer's common stock may be traded, equals or exceeds $11.50 for any 20 days within any 30 trading day period. |
14. These warrants are directly owned by Heckmann Acquisition, LLC. Of these warrants, Messrs. Ezzell and Anderson each have an interest in 75,000 warrants by virtue of their interest in Heckmann Acquisition, LLC. |
Remarks: |
/s/Donald G. Ezzell, Attorney-in-Fact for Richard J. Heckmann | 02/16/2010 | |
** 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 Number. |