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*
(Street)
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2. Issuer Name and Ticker or Trading Symbol
WESTERN GOLDFIELDS INC [ WGDF.OTCBB ] |
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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3. Date of Earliest Transaction
(Month/Day/Year) 12/16/2003 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed
(Month/Day/Year) |
6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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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 | 12/16/2003 | P | 100,000 | A | (1) | 100,000 | I | Mother | ||
Common Stock | 12/16/2003 | P | 25,000 | A | (1) | 25,000 | I | Wife | ||
Common Stock | 03/14/2004 | J(2) | 100,000 | A | (2) | 200,000 | I | Mother | ||
Common Stock | 03/14/2004 | J(3) | 25,000 | A | (3) | 50,000 | I | Wife | ||
Common Stock | 05/10/2004 | J(4) | 7,668 | A | (4) | 207,668 | I | Mother | ||
Common Stock | 05/10/2004 | J(5) | 1,917 | A | (5) | 51,917 | I | Wife | ||
Common Stock | 02/17/2006 | P | 133,334 | A | (6) | 341,002 | I | Mother | ||
Common Stock | 02/17/2006 | P | 500,000 | A | (6) | 551,917 | I | Wife | ||
Common Stock | 12/13/2006 | J(7) | 100,000 | A | $1(7) | 441,002 | I | Mother | ||
Common Stock | 12/13/2006 | J(8) | 25,000 | A | $1(8) | 576,917 | I | Wife | ||
Common Stock | 06/29/2007 | J(9) | 66,667 | A | $0.45(9) | 507,669 | I | Mother | ||
Common Stock | 06/29/2007 | J(10) | 250,000 | A | $0.45(10) | 826,917 | I | Wife |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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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 | ||||||||
Warrants to purchase Common Stock | $1 | 12/16/2003 | P | 100,000 | 12/16/2003 | 12/16/2006 | Common Stock | 100,000 | (1) | 100,000 | I | Mother | |||
Warrants to purchase Common Stock | $1 | 12/16/2003 | P | 25,000 | 12/16/2003 | 12/16/2006 | Common Stock | 25,000 | (1) | 25,000 | I | Wife | |||
Warrants to purchase Common Stock | $0.45 | 02/17/2006 | P | 66,667 | 02/17/2006 | 02/17/2008 | Common Stock | 66,667 | (6) | 66,667 | I | Mother | |||
Warrants to purchase Common Stock | $0.45 | 02/17/2006 | P | 250,000 | 02/17/2006 | 02/17/2008 | Common Stock | 250,000 | (6) | 250,000 | I | Wife | |||
Warrants to purchase Common Stock | $1 | 12/13/2006 | C | 100,000 | 12/16/2003 | 12/16/2006 | Common Stock | 100,000 | (7) | 0 | I | Mother | |||
Warrants to purchase Common Stock | $1 | 12/13/2006 | C | 25,000 | 12/16/2003 | 12/16/2006 | Common Stock | 25,000 | (8) | 0 | I | Wife | |||
Warrants to purchase Common Stock | $0.45 | 06/29/2007 | C | 66,667 | 02/17/2006 | 02/17/2008 | Common Stock | 66,667 | (9) | 0 | I | Mother | |||
Warrants to purchase Common Stock | $0.45 | 06/29/2007 | C | 250,000 | 02/17/2006 | 02/17/2008 | Common Stock | 250,000 | (10) | 0 | I | Wife |
Explanation of Responses: |
1. Each unit consisting of one share of common stock ("Share") of Western Goldfields, Inc. (the "Company") and one warrant to purchase one share of common stock exercisable for $1.00 ("2003 Warrant") was purchased for $0.80 ("2003 Unit"). |
2. Pursuant to the registration rights agreement between the Company and Muriel A. Ruth, mother of Gerald B. Ruth ("Mother"), dated December 16, 2003 (the "Agreement One"), the Company issued to Mother one Share for each 2003 Unit purchased by Mother on December 16, 2003, at no cost to Mother, in anticipation of its failure to fulfill its obligation under the agreement to register with the Securities and Exchange Commission the Share portion of the 2003 Units no later than March 31,2004. |
3. Pursuant to the registration rights agreement between the Company and Sandra Meddick-Ruth, wife of Gerald B. Ruth ("Wife") , dated December 16, 2003 (the "Agreement Two"), the Company issued to Wife one Share for each 2003 Unit purchased by Wife on December 16, 2003, at no cost to Wife, in anticipation of its failure to fulfill its obligation under the agreement to register with the Securities and Exchange Commission the Share portion of the 2003 Units no later than March 31, 2004. |
4. The Company issued to Mother 7,668 common shares in lieu of a cash payment of $3,834 owed by the Company to Mother as a result of the Company's failure to perform certain actions under the Agreement One. |
5. The Company issued to Wife 1,917 common shares in lieu of a cash payment of $958.50 owed by the Company to Wife as a result of the Company's failure to perform certain actions under the Agreement Two. |
6. Each unit consisting of one Share and one half warrant to purchase one Share exercisable for $0.45 ("2006 Warrants") was purchased for $0.30. |
7. Mother exercised 100,000 2003 Warrants to purchase Shares at $1.00 per warrant. |
8. Wife exercised 25,000 2003 Warrants to purchase Shares at $1.00 per warrant. |
9. Mother exercised 66,667 2006 Warrants to purchase Shares at $0.45 per warrant. |
10. Wife exercised 250,000 2006 Warrants to purchase Shares at $0.45 per warrant. |
/s/ Gerald Ruth | 08/09/2007 | |
** 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). | ||
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. |