SEC Form 3
FORM 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES

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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1. Name and Address of Reporting Person*
POTVIN JEAN CHARLES

(Last) (First) (Middle)
C/O GOLD RESERVE CORP
926 W. SPRAGUE AVENUE, SUITE 200

(Street)
SPOKANE WA 99201

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
01/01/2010
3. Issuer Name and Ticker or Trading Symbol
GOLD RESERVE INC [ GRZ ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
Officer (give title below) Other (specify below)
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Class A Common Shares 156,604 D
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Options 09/27/2006 09/27/2011 Class A Common Shares 50,000 $4.19 D
Stock Options 12/04/2007 05/27/2010 Class A Common Shares 13,333 $4.834 D
Stock Options 12/04/2007 11/27/2010 Class A Common Shares 13,333 $4.834 D
Stock Options 12/04/2007 05/27/2011 Class A Common Shares 13,333 $4.834 D
Stock Options (1) 12/05/2013 Class A Common Shares 53,336 $0.29 D
Stock Options 03/18/2010 03/18/2014 Class A Common Shares 35,000 $0.73 D
Explanation of Responses:
1. One-third vest upon grant date of December 5, 2008 and the remaining vest annually over a two year period.
Mary E. Smith, Attorney in Fact for Jean Charles Potvin 01/06/2010
** 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 5 (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.