-----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, SimEJXYJK2zJsmonfrNWLDVToUV8Iv4VE6YaLtLQ9lbiuc6TUrptD+KlI3k3I5po k4wTD85xQRo280SmJnOseA== 0001144204-11-009595.txt : 20110217 0001144204-11-009595.hdr.sgml : 20110217 20110217162730 ACCESSION NUMBER: 0001144204-11-009595 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20110217 DATE AS OF CHANGE: 20110217 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: Culotta Marilyn CENTRAL INDEX KEY: 0001456500 FILING VALUES: FORM TYPE: SC 13G/A MAIL ADDRESS: STREET 1: 9101 W. SAHARA AVENUE #105B11 CITY: LAS VEGAS STATE: NV ZIP: 89117 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: POKER MAGIC INC CENTRAL INDEX KEY: 0001425355 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-AMUSEMENT & RECREATION SERVICES [7900] IRS NUMBER: 204709758 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: 1934 Act SEC FILE NUMBER: 005-84159 FILM NUMBER: 11621242 BUSINESS ADDRESS: STREET 1: 130 LAKE STREET WEST CITY: WAYZATA STATE: MN ZIP: 55391 BUSINESS PHONE: 952 473 3442 MAIL ADDRESS: STREET 1: 130 LAKE STREET WEST CITY: WAYZATA STATE: MN ZIP: 55391 SC 13G/A 1 v211918_sc13ga.txt SECURITIES AND EXCHANGE COMMISSION Washington, DC 20549 SCHEDULE 13G (Rule 13d-102) INFORMATION TO BE INCLUDED IN STATEMENTS FILED PURSUANT TO RULES 13d-1(b), (c), AND (d) AND AMENDMENTS THERETO FILED PURSUANT TO RULE 13d-2 (Amendment No. 2)* Poker Magic, Inc. - -------------------------------------------------------------------------------- (Name of Issuer) Common Stock - -------------------------------------------------------------------------------- (Title of Class of Securities) 73086A 10 1 - -------------------------------------------------------------------------------- (CUSIP Number) December 31, 2010 - -------------------------------------------------------------------------------- (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 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). CUSIP No. 73086A 10 1 13G Page 2 of 5 Pages - -------------------------------------------------------------------------------- 1. NAME OF REPORTING PERSONS Marilyn Culotta - -------------------------------------------------------------------------------- 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] (b) [_] - -------------------------------------------------------------------------------- 3. SEC USE ONLY - -------------------------------------------------------------------------------- 4. CITIZENSHIP OR PLACE OF ORGANIZATION USA - -------------------------------------------------------------------------------- NUMBER OF 5. SOLE VOTING POWER SHARES 509,500 ----------------------------------------------------------------- BENEFICIALLY 6. SHARED VOTING POWER OWNED BY 0 ----------------------------------------------------------------- EACH 7. SOLE DISPOSITIVE POWER REPORTING 509,500 ----------------------------------------------------------------- PERSON 8. SHARED DISPOSITIVE POWER WITH 0 - -------------------------------------------------------------------------------- 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 509,500 SHARES - -------------------------------------------------------------------------------- 10. CHECK IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES (SEE INSTRUCTIONS) [ ] - -------------------------------------------------------------------------------- 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 4.6% - -------------------------------------------------------------------------------- 12. TYPE OF REPORTING PERSON* IN - -------------------------------------------------------------------------------- CUSIP No. 73086A 10 1 13G Page 3 of 5 Pages - -------------------------------------------------------------------------------- Item 1(a). Name of Issuer: Poker Magic, Inc. - -------------------------------------------------------------------------------- Item 1(b). Address of Issuer's Principal Executive Offices: 130 Lake Street West, Suite 300, Wayzata, MN 55391 - -------------------------------------------------------------------------------- Item 2(a). Name of Person Filing: Marilyn Culotta - -------------------------------------------------------------------------------- Item 2(b). Address of Principal Business Office, or if none, Residence: 9101 W. Sahara Avenue #105b11, Las Vegas, NV 89117 - -------------------------------------------------------------------------------- Item 2(c). Citizenship: Ms. Culotta is a citizen of the United States. - -------------------------------------------------------------------------------- Item 2(d). Title of Class of Securities: Common Stock - -------------------------------------------------------------------------------- Item 2(e). CUSIP Number: 73086A 10 1 - -------------------------------------------------------------------------------- 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 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 (15 U.S.C. 80a-3); (j) [_] A non-U.S. institution in accordance with ss. 240.13d-1(b)(1)(ii)(J); (k) [_] Group, in accordance with ss. 240.13d-1(b)(1)(ii)(K). If filing as a non-U.S. institution in accordance with ss.240.13d-1(b)(1) (ii)(J), please specify the type of institution: __________________. CUSIP No. 73086A 10 1 13G Page 4 of 5 Pages 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: 509,500 SHARES ---------------------------------------------------------------------- (b) Percent of class: 4.6% (Based upon 11,008,224 shares outstanding on December 31, 2010 as reported by the Issuer) ---------------------------------------------------------------------- (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote: 509,500 ----------------------- (ii) Shared power to vote or to direct the vote: 0 -------------------- (iii) Sole power to dispose or to direct the disposition of: 509,500 ---------- (iv) Shared power to dispose or to direct the disposition of: 0 -------- - -------------------------------------------------------------------------------- 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 the beneficial owner of more than 5 percent of the class of securities, check the following: [X] - -------------------------------------------------------------------------------- Item 6. Ownership of More Than Five Percent on Behalf of Another Person. N/A - -------------------------------------------------------------------------------- Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company or Control Person. N/A - -------------------------------------------------------------------------------- Item 8. Identification and Classification of Members of the Group. N/A - -------------------------------------------------------------------------------- Item 9. Notice of Dissolution of Group. N/A - -------------------------------------------------------------------------------- Item 10. Certifications. (a) Not applicable (b) Not applicable (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. 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. Dated: February 17, 2011 /s/ Marilyn Culotta ----------------------------------- Marilyn Culotta -----END PRIVACY-ENHANCED MESSAGE-----