SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

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).
1. Name and Address of Reporting Person*
BUTLEIN ERIC

(Last) (First) (Middle)
9303 N VALLEY HILL ROAD

(Street)
MILWAUKEE WI 53217

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
CASH TECHNOLOGIES INC [ TQ ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
Director X 10% Owner
Officer (give title below) Other (specify below)
3. Date of Earliest Transaction (Month/Day/Year)
10/15/2005
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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 Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 1,298,227(1) I By Ejada Limited Partnership
Common Stock 98,947 I By 1994 Revocable Trust
Common Stock 10/15/2005 P 140,000 A (2) 507,631 I By Tikkun Olam Foundation
Common Stock 98,872 I By Ada Partners, LLC
Common Stock 5,200 I By JADA Grantor Retained Annuity Trust
Common Stock 10,000 I By EADA Grantor Retained Annuity Trust
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Series B 8% Cumulative Convertible Preferred Stock (3) 08/23/2000 (3) Common Stock 80,000 80,000 I By Ejada Limited Partnership
Series C 8% Convertible Preferred Stock (4) 01/09/2001 (4) Common Stock 480,769 480,769 I By Ejada Limited Partnership
Warrants (right to buy) $1.5 09/09/2004 09/09/2009 Common Stock 102,231 102,231 I By Ejada Limited Partnership
Series G 6% Cumulative Convertible Preferred Stock (5) 09/10/2004 (5) Common Stock 28,571 28,571 I By Ejada Limited Partnership
Warrants (right to buy) $2.5 09/09/2004 09/09/2009 Common Stock 10,000 10,000 I By Ejada Limited Partnership
Warrants (right to buy) $3.5 09/09/2004 09/09/2009 Common Stock 15,000 15,000 I By Ejada Limited Partnership
Warrants (right to buy) $1.5 09/17/2004 09/17/2009 Common Stock 75,000 75,000 I By Ejada Limited Partnership
Warrants (right to buy) $1.75 01/10/2005 01/10/2010 Common Stock 240,000 240,000 I By Ejada Limited Partnership
Warrants (right to buy) $1.75 02/01/2005 02/01/2010 Common Stock 90,000 90,000 I By Ejada Limited Partnership
Warrants (right to buy) $2 05/31/2005 05/31/2010 Common Stock 25,000 25,000 I By Ejada Limited Partnership
Warrants (right to buy) $1 09/14/2004 09/14/2009 Common Stock 50,000 50,000 I By 1994 Revocable Trust
Warrants (right to buy) $1 12/14/2004 12/14/2009 Common Stock 25,000 25,000 I By 1994 Revocable Trust
Warrants (right to buy) $0.95 10/30/2002 10/30/2007 Common Stock 97,369 97,369 I By Tikkun Olam Foundation
Warrants (right to buy) $1.5 09/23/2004 09/23/2009 Common Stock 52,631 52,631 I By Tikkun Olam Foundation
Warrants (right to buy) $1.75 02/01/2005 02/01/2010 Common Stock 60,000 60,000 I By Tikkun Olam Foundation
Warrants (right to buy) $1.75 02/02/2005 02/02/2010 Common Stock 30,000 30,000 I By Ada Partners, LLC
Warrants (right to buy) $2.5 10/15/2005 P 140,000 10/07/2005 10/07/2010 Common Stock 140,000 (2) 140,000 I By Tikkun Olam Foundation
1. Name and Address of Reporting Person*
BUTLEIN ERIC

(Last) (First) (Middle)
9303 N VALLEY HILL ROAD

(Street)
MILWAUKEE WI 53217

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
BUTLEIN JAYNE

(Last) (First) (Middle)

(Street)

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
1. Name and Address of Reporting Person*
EJADA L P

(Last) (First) (Middle)

(Street)

(City) (State) (Zip)

Relationship of Reporting Person(s) to Issuer
Director X 10% Owner
Officer (give title below) Other (specify below)
Explanation of Responses:
1. Includes 76,685 shares of common stock received by the Ejada Limited Partnership pursuant to the payment of accrued dividends relating to the issuer's Series B 8% Cumulative Convertible Preferred Stock and Series C 8% Convertible Preferred Stock in common stock, which was paid to all holders of the such preferred stock on a pro rata basis, and for which reporting is not required under Rule 16a-9(a).
2. The Tikkun Olam Foundation purchased 140,000 shares of common stock and warrants to purchase 140,000 shares of common stock in a private placement for an aggregate purchase price of $140,000.
3. The Series B Convertible Preferred Stock is convertible into common stock at any time following the issue date, at the liquidation price ($5.00) divided by the lesser of: (a) $5.50 per share; or (b) the average closing price for the issuer's common stock for the five trading days ending on the trading day prior to the date of the conversion notice; provided, however, in no event will the conversion rate be less than $2.50 per share.
4. The Series C Convertible Preferred Stock is convertible into common stock at any time following the issue date. The Series C Convertible Preferred Stock is convertible into common stock on the basis of one share of common stock for each share of preferred stock.
5. The Series G Convertible Preferred Stock is convertible into common stock at any time following the issue date. The conversion price of the Series G Convertible Preferred Stock is 80% of the "market price" of the issuer's common stock at the time of the conversion, subject to a minimum of $1.75 per share and a maximum of $2.75 per share. The "market price" is the average of the closing prices of the issuer's common stock for the 20 trading days immediately preceding the conversion date. At the issuer's option, the issuer may require conversion when the "market price" reaches $9 per share.
Remarks:
The reporting persons for the purposes of this Form 4 are Mr. Eric Butlein, Ms. Jayne Butlein and the Ejada Limited Partnership, who constitute a "group" for purposes of Section 13(d) of the Securities Exchange Act of 1934. The information set forth in Items 2, 3, 4, 5 and 6 of the heading to this Form 4 are applicable to each reporting person.
Eric Butlein 11/15/2005
Jayne Butlein 11/15/2005
Eric Butlein, as General Partner of Ejada Limited Partnership 11/15/2005
Jayne Butlein, as General Partner of Ejada Limited Partnership 11/15/2005
** 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).
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