-----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, GwY2Cbu2WJXrroYS90j6ieucUgR6hxSeTRnqamM9J1O+lJfKTFHt0dOxJdIAfonV hXfHnAPOuwFZ1QCZSGfqdw== 0001020488-00-000066.txt : 20000425 0001020488-00-000066.hdr.sgml : 20000425 ACCESSION NUMBER: 0001020488-00-000066 CONFORMED SUBMISSION TYPE: SC 13G/A PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 20000424 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: GALAXY ENTERPRISES INC /NV/ CENTRAL INDEX KEY: 0001063450 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROGRAMMING, DATA PROCESSING, ETC. [7370] IRS NUMBER: 880315212 STATE OF INCORPORATION: NV FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: SC 13G/A SEC ACT: SEC FILE NUMBER: 005-58527 FILM NUMBER: 606873 BUSINESS ADDRESS: STREET 1: 754 EAST TECHNOLOGY AVE CITY: OREM STATE: UT ZIP: 84057 BUSINESS PHONE: 8012270004 MAIL ADDRESS: STREET 1: 754B EAST TECHNOLOGY AVE CITY: OREM STATE: UT ZIP: 84057 FILED BY: COMPANY DATA: COMPANY CONFORMED NAME: POELMAN JAY CENTRAL INDEX KEY: 0001106538 STANDARD INDUSTRIAL CLASSIFICATION: [] FILING VALUES: FORM TYPE: SC 13G/A BUSINESS ADDRESS: STREET 1: 754 EAST TECHNOLOGY AVE CITY: OREM STATE: UT ZIP: 84097 BUSINESS PHONE: 8012270004 MAIL ADDRESS: STREET 1: 754 TECHNOLOGY AVE CITY: OREM STATE: UT ZIP: 84097 SC 13G/A 1 SCHEDULE 13G AMENDMENT 1 UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 SCHEDULE 13G Under the Securities Exchange Act of 1934 (Amendment No. 1)* GALAXY ENTERPRISES, INC. - -------------------------------------------------------------------------------- (Name of Issuer) COMMON SHARES - ------------------------------------------------------------------------------- (Title of Class of Securities) - ------------------------------------------------------------------------------- (CUSIP Number) John J. Poelman 754 East Technology Avenue Orem, Utah 84097 801.227.0004 - ------------------------------------------------------------------------------- (Name, Address and Telephone Number of Person Authorized to Receive Notices and Communications) DECEMBER 31, 1999 - ------------------------------------------------------------------------------- (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) [ ] Rule 13d-1(c) [X] 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 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). CUSIP No. 13G Page 2 of 4 Pages ________________________________________________________________________________ 1. NAME OF REPORTING PERSONS I.R.S. IDENTIFICATION NO. OF ABOVE PERSONS (ENTITIES ONLY) John J. Poelman ________________________________________________________________________________ 2. CHECK THE APPROPRIATE BOX IF A MEMBER OF A GROUP* (a) [_] (b) [X] ________________________________________________________________________________ 3. SEC USE ONLY ________________________________________________________________________________ 4. CITIZENSHIP OR PLACE OF ORGANIZATION United States ________________________________________________________________________________ NUMBER OF 5. SOLE VOTING POWER SHARES 0 _________________________________________________________________ BENEFICIALLY 6. SHARED VOTING POWER OWNED BY 980,213 _________________________________________________________________ EACH 7. SOLE DISPOSITIVE POWER REPORTING 580,213 _________________________________________________________________ PERSON 8. SHARED DISPOSITIVE POWER WITH 400,000 ________________________________________________________________________________ 9. AGGREGATE AMOUNT BENEFICIALLY OWNED BY EACH REPORTING PERSON 980,213 ________________________________________________________________________________ 10. CHECK BOX IF THE AGGREGATE AMOUNT IN ROW (9) EXCLUDES CERTAIN SHARES* [_] ________________________________________________________________________________ 11. PERCENT OF CLASS REPRESENTED BY AMOUNT IN ROW (9) 15.79% ________________________________________________________________________________ 12. TYPE OF REPORTING PERSON* IN ________________________________________________________________________________ *SEE INSTRUCTIONS BEFORE FILLING OUT! CUSIP No. 13G Page 3 of 4 Pages ________________________________________________________________________________ Item 1(a). Name of Issuer: Galaxy Enterprises, Inc. ________________________________________________________________________________ Item 1(b). Address of Issuer's Principal Executive Offices: 754 East Technology Avenue, Orem, Utah 84097 ________________________________________________________________________________ Item 2(a). Name of Person Filing: John J. Poelman ("Poelman") ________________________________________________________________________________ Item 2(b). Address of Principal Business Office, or if None, Residence: 754 East Technology Avenue, Orem, Utah 84097 ________________________________________________________________________________ Item 2(c). Citizenship: United States ________________________________________________________________________________ Item 2(d). Title of Class of Securities: Common Shares ________________________________________________________________________________ Item 2(e). CUSIP Number: ________________________________________________________________________________ Item 3. If This Statement is Filed Pursuant to Rule 13d-1(b), or 13d-2(b) or (c), Check Whether the Person Filing is a: Not Applicable CUSIP No. 13G Page 4 of 4 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: 980,213 Shares (b) Percent of class: 15.79% (c) Number of shares as to which such person has: (i) Sole power to vote or to direct the vote 0, (ii) Shared power to vote or to direct the vote 980,213, (iii) Sole power to dispose or to direct the disposition of 580,213, (iv) Shared power to dispose or to direct the disposition of 400,000. ________________________________________________________________________________ Item 5. Ownership of Five Percent or Less of a Class. Not Applicable ________________________________________________________________________________ Item 6. Ownership of More Than Five Percent on Behalf of Another Person. Not Applicable ________________________________________________________________________________ Item 7. Identification and Classification of the Subsidiary Which Acquired the Security Being Reported on by the Parent Holding Company. Not Applicable ________________________________________________________________________________ Item 8. Identification and Classification of Members of the Group. Not Applicable ________________________________________________________________________________ Item 9. Notice of Dissolution of Group. Not Applicable ________________________________________________________________________________ Item 10. Certifications. Not Applicable 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. April 6, 2000 ---------------------------------------- (Date) /s/ John J. Poelman ---------------------------------------- (Signature) John J. Poelman, President & CEO ---------------------------------------- (Name/Title) Note. Schedules filed in paper format shall include a signed original and five copies of the schedule, including all exhibits. See Rule 13d-7(b) 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). -----END PRIVACY-ENHANCED MESSAGE-----