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*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 05/04/2005 |
3. Issuer Name and Ticker or Trading Symbol
CAPCO ENERGY INC [ CGYN.OB ] |
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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5. If Amendment, Date of Original Filed
(Month/Day/Year) |
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Beneficially Owned | |||
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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) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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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 | ||||
Warrants to Purchase Common Stock, $0.001 par value | 12/03/2004 | 12/03/2009 | Common Stock, $0.001 par value | 833,333 | $0.176 | D(1) | |
Warrants to Purchase Common Stock, $0.001 par value | 12/03/2004 | 12/03/2009 | Common Stock, $0.001 par value | 833,333 | $0.176 | I | footnote(2) |
Warrants to Purchase Common Stock, $0.001 par value | 12/27/2004 | 12/27/2009 | Common Stock, $0.001 par value | 10,035,213 | $0.195 | D(1) | |
Warrants to Purchase Common Stock, $0.001 par value | 12/27/2004 | 12/27/2009 | Common Stock, $0.001 par value | 10,035,213 | $0.195 | I | footnote(2) |
Warrants to Purchase Common Stock, $0.001 par value | 05/04/2005 | 05/04/2010 | Common Stock, $0.001 par value | 24,032 | $0.195 | D(1) | |
Warrants to Purchase Common Stock, $0.001 par value | 05/04/2005 | 05/04/2010 | Common Stock, $0.001 par value | 24,032 | $0.195 | I | footnote(2) |
Warrants to Purchase Common Stock, $0.001 par value | 05/04/2005 | 05/04/2010 | Common Stock, $0.001 par value | 13,333,333 | $0.3 | D(1) | |
Warrants to Purchase Common Stock, $0.001 par value | 05/04/2005 | 05/04/2010 | Common Stock, $0.001 par value | 13,333,333 | $0.3 | I | footnote(2) |
$720,000 12% Convertible Notes | 06/30/2004 | 06/30/2007 | Common Stock, $0.001 par value | 3,600,000 | $0.2 | D(3) | |
$720,000 12% Convertible Notes | 06/30/2004 | 06/30/2007 | Common Stock, $0.001 par value | 3,600,000 | $0.2 | I | footnote(4) |
$660,000 9% Convertible Notes | 09/15/2004 | 09/15/2007 | Common Stock, $0.001 par value | 4,125,000 | $0.16 | D(5) | |
$660,000 9% Convertible Notes | 09/15/2004 | 09/15/2007 | Common Stock, $0.001 par value | 4,125,000 | $0.16 | I | footnote(6) |
1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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1. Name and Address of Reporting Person*
(Street)
Relationship of Reporting Person(s) to Issuer
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Explanation of Responses: |
1. These Warrants are owned directly by Hoactzin Partners, L.P. ("Hoactzin"). |
2. These Warrants are owned indirectly by Dolphin Advisors, LLC ("Dolphin Advisors"), Dolphin Management Inc. ("Dolphin Management") and Peter E. Salas ("Mr. Salas"). Mr. Salas is the sole shareholder and president of Dolphin Management, which is the sole managing member of Dolphin Advisors, which is the sole managing general partner of Hoactzin. Each of Mr. Salas, Dolphin Management and Dolphin Advisors disclaims beneficial ownership, within the meaning of Section 16 of the Exchange Act, or otherwise of such portion of the Warrants in which such reporting person has no actual pecuniary interest therein. |
3. These Convertible Notes are owned directly by Dolphin Offshore Partners, L.P. ("Dolphin Offshore"). |
4. These Convertible Notes are owned indirectly by Dolphin Management and Mr. Salas. Mr. Salas is the sole shareholder and president of Dolphin Management, which is the sole managing general partner of Dolphin Offshore. Each of Mr. Salas and Dolphin Management disclaims beneficial ownership, within the meaning of Section 16 of the Exchange Act, or otherwise of such portion of the Convertible Notes in which such reporting person has no actual pecuniary interest therein. |
5. These Convertible Notes are owned directly by Dolphin Offshore. |
6. These Convertible Notes are owned indirectly by Dolphin Management and Mr. Salas. Mr. Salas is the sole shareholder and president of Dolphin Management, which is the sole managing general partner of Dolphin Offshore. Each of Mr. Salas and Dolphin Management disclaims beneficial ownership, within the meaning of Section 16 of the Exchange Act, or otherwise of such portion of the Convertible Notes in which such reporting person has no actual pecuniary interest therein. |
Remarks: |
The reporting person is a member of a Section 13(d) group that owns more than 10% of the issuer's outstanding common stock. There are five members of such group. Each of the foregoing persons, with exception of the aforementioned reporting person, are joint filers, as permitted under Rule 16(a)-3(j) of the Securities Exchange Act of 1934, as amended (the "Exchange Act"). Exhibit List Exhibit 99 - Joint Filer Information |
Peter E. Salas | 05/17/2005 | |
** 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 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. |