0001004878-12-000103.txt : 20120413
0001004878-12-000103.hdr.sgml : 20120413
20120413111339
ACCESSION NUMBER: 0001004878-12-000103
CONFORMED SUBMISSION TYPE: SC 13G
PUBLIC DOCUMENT COUNT: 1
FILED AS OF DATE: 20120413
DATE AS OF CHANGE: 20120413
SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: SYNERGY RESOURCES CORP
CENTRAL INDEX KEY: 0001413507
STANDARD INDUSTRIAL CLASSIFICATION: OIL AND GAS FIELD EXPLORATION SERVICES [1382]
IRS NUMBER: 202835920
STATE OF INCORPORATION: CO
FISCAL YEAR END: 0831
FILING VALUES:
FORM TYPE: SC 13G
SEC ACT: 1934 Act
SEC FILE NUMBER: 005-86688
FILM NUMBER: 12757827
BUSINESS ADDRESS:
STREET 1: 20203 HIGHWAY 60
CITY: PLATTEVILLE
STATE: CO
ZIP: 80651
BUSINESS PHONE: 303-591-7413
MAIL ADDRESS:
STREET 1: 20203 HIGHWAY 60
CITY: PLATTEVILLE
STATE: CO
ZIP: 80651
FORMER COMPANY:
FORMER CONFORMED NAME: Brishlin Resources, Inc.
DATE OF NAME CHANGE: 20071217
FORMER COMPANY:
FORMER CONFORMED NAME: Blue Star Energy Inc
DATE OF NAME CHANGE: 20070926
FILED BY:
COMPANY DATA:
COMPANY CONFORMED NAME: SYNERGY RESOURCES CORP
CENTRAL INDEX KEY: 0001413507
STANDARD INDUSTRIAL CLASSIFICATION: OIL AND GAS FIELD EXPLORATION SERVICES [1382]
IRS NUMBER: 202835920
STATE OF INCORPORATION: CO
FISCAL YEAR END: 0831
FILING VALUES:
FORM TYPE: SC 13G
BUSINESS ADDRESS:
STREET 1: 20203 HIGHWAY 60
CITY: PLATTEVILLE
STATE: CO
ZIP: 80651
BUSINESS PHONE: 303-591-7413
MAIL ADDRESS:
STREET 1: 20203 HIGHWAY 60
CITY: PLATTEVILLE
STATE: CO
ZIP: 80651
FORMER COMPANY:
FORMER CONFORMED NAME: Brishlin Resources, Inc.
DATE OF NAME CHANGE: 20071217
FORMER COMPANY:
FORMER CONFORMED NAME: Blue Star Energy Inc
DATE OF NAME CHANGE: 20070926
SC 13G
1
schedule13glaufer4-12.txt
LAUFER SCHEDULE 13G
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
SCHEDULE 13G
Under the Securities Exchange Act of 1934
(Amendment No. ___________)
SYNERGY RESOURCES CORPORATION
-----------------------------
(Name of Issuer)
Common Stock
----------------------
(Title of Class of Securities)
87164 P 103
--------------------
(CUSIP Number)
December 31, 2011
---------------------------------
(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)
[ ] 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).
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.
CUSIP No. 87164 P 103
-------------------
1. Names of Reporting Person Wayne L. Laufer
----------------------------
I.R.S. Identification Nos. of above person (entities only).
----------
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 U.S.A.
-------------------------------
Number of Shares 5. Sole Voting Power 3,000,000
Beneficially -------------------------------
Owned By Each
Reporting 6. Shared Voting Power 106,250
Person with: -------------------------------
7. Sole Dispositive Power 3,000,000
----------------------------
8. Shared Dispositive Power 106,250
--------------------------
9. Aggregate Amount Beneficially Owned by Each Reporting Person 3,106,250
---------
10. Check if the Aggregate Amount in Row (9) Excludes Certain Shares
(See Instructions)
------
11. Percent of Class Represented by Amount in Row (9) 6.1%
--------------------
12. Type of Reporting Person (See Instructions) IN
---------------------------
2
Item 1.
(a) Name of Issuer Synergy Resources Corporation
--------------------------------------------------------
(b) Address of Issuer's Principal Executive Offices 20203 Highway 60,
------------------------
Platteville, CO 80651
---------------------------------------------------------------------------
Item 2.
(a) Name of Person Filing Wayne L. Laufer
-------------------------------------------------
(b) Address of Principal Business Office or, if none, Residence 4989 Joewood
------------
Drive, Sanibel, FL 33957
---------------------------------------------------------------------------
(c) Citizenship USA
-----------------------------------------------------------
(d) Title of Class of Securities Common Stock
------------------------------------------
(e) CUSIP Number 87164P103
----------------------------------------------------------
Item 3. If this statement is filed pursuant to ss.ss.240.13d-1(b) or
240.13d-2(b) or (c), 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);
(g) A parent holding company or control person in accordance with ss.
240.13d-1(b)(1)(ii)(G);
(h) A savings associations 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. Ownership.
Provide the following information regarding the aggregate number and
percentage of the class of securities of the issuer identified in Item 1.
(a) Amount beneficially owned: 3,106,250
--------------------------------------------
3
(b) Percent of class: 6.1%
-----------------------------------------------------
(c) Number of shares as to which the person has:
(i) Sole power to vote or to direct the vote 3,000,000
----------------------
(ii) Shared power to vote or to direct the vote 106,250
-------------------
(iii) Sole power to dispose or to direct the
disposition of 3,000,000
----------------------
(iv) Shared power to dispose or to direct the
disposition of 106,250
----------------------
Instruction. For computations regarding securities which represent a right to
acquire an underlying security see ss.240.13d-3(d)(1).
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 [ ].
Instruction: Dissolution of a group requires a response to this item.
Item 6. Ownership of More than Five Percent on Behalf of Another Person.
If any other person is known to have the right to receive or the power to
direct the receipt of dividends from, or the proceeds from the sale of, such
securities, a statement to that effect should be included in response to this
item and, if such interest relates to more than five percent of the class, such
person should be identified. A listing of the shareholders of an investment
company registered under the Investment Company Act of 1940 or the beneficiaries
of employee benefit plan, pension fund or endowment fund is not required.
Item 7. Identification and Classification of the Subsidiary Which Acquired the
Security Being Reported on By the Parent Holding Company
If a parent holding company has filed this schedule, pursuant to Rule
13d-1(b)(ii)(G), so indicate under Item 3(g) and attach an exhibit stating the
identity and the Item 3 classification of the relevant subsidiary. If a parent
holding company has filed this schedule pursuant to Rule 13d-1(c) or Rule
13d-1(d), attach an exhibit stating the identification of the relevant
subsidiary.
Item 8. Identification and Classification of Members of the Group
If a group has filed this schedule pursuant to ss.240.13d-1(b)(1)(ii)(J),
so indicate under Item 3(j) and attach an exhibit stating the identity and Item
3 classification of each member of the group. If a group has filed this schedule
pursuant to ss.240.13d-1(c) or ss.240.13d-1(d), attach an exhibit stating the
identity of each member of the group.
4
Item 9. Notice of Dissolution of Group
Notice of dissolution of a group may be furnished as an exhibit stating the
date of the dissolution and that all further filings with respect to
transactions in the security reported on will be filed, if required, by members
of the group, in their individual capacity. See Item 5.
Item 10. Certification
(a) The following certification shall be included if the statement is filed
pursuant to ss.240.13d-1(b):
By signing below I certify that, to the best of my knowledge and belief,
the securities referred to above were acquired and are held in the ordinary
course of business and 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 that purpose or effect.
(b) The following certification shall be included if the statement is filed
pursuant to ss.240.13d-1(c):
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 that purpose
or effect.
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.
4/10/2012
--------------------------------------
Date
/s/ Wayne L. Laufer
--------------------------------------
Signature
Wayne L. Laufer
------------------------------------
Name/Title
The original statement shall be signed by each person on whose behalf the
statement is filed or his authorized representative. If the statement is signed
on behalf of a person by his authorized representative other than an executive
officer or general partner of the filing person, evidence of the
representative's authority to sign on behalf of such person shall be filed with
the statement, provided, however, that a power of attorney for this purpose
which is already on file with the Commission may be incorporated by reference.
The name and any title of each person who signs the statement shall be typed or
printed beneath his signature.
NOTE: Schedules filed in paper format shall include a signed original and five
copies of the schedule, including all exhibits. See ss.240.13d-7 for other
parties for whom copies are to be sent.
Attention: Intentional misstatements or omissions of fact constitute Federal
criminal violations (See 18 U.S.C. 1001)
6