-----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, KauiXw9XJwGABX3RAVGt+gByYKKcj57ftmUJ4z+envH6C2iJ4BbldoXf7xDLNU9S iCOHy2/SswCCpv773NBj4w== 0001140361-10-033905.txt : 20100816 0001140361-10-033905.hdr.sgml : 20100816 20100816202855 ACCESSION NUMBER: 0001140361-10-033905 CONFORMED SUBMISSION TYPE: 5 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20100630 FILED AS OF DATE: 20100816 DATE AS OF CHANGE: 20100816 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: PARK CITY GROUP INC CENTRAL INDEX KEY: 0000050471 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-COMPUTER PROCESSING & DATA PREPARATION [7374] IRS NUMBER: 371454128 FISCAL YEAR END: 0630 BUSINESS ADDRESS: STREET 1: 3160 PINEBROOK ROAD CITY: PARK CITY STATE: UT ZIP: 84098 BUSINESS PHONE: 435-645-2000 MAIL ADDRESS: STREET 1: 3160 PINEBROOK ROAD CITY: PARK CITY STATE: UT ZIP: 84098 FORMER COMPANY: FORMER CONFORMED NAME: FIELDS TECHNOLOGIES INC DATE OF NAME CHANGE: 20010626 FORMER COMPANY: FORMER CONFORMED NAME: AMERINET GROUP COM INC DATE OF NAME CHANGE: 19990803 FORMER COMPANY: FORMER CONFORMED NAME: EQUITY GROWTH SYSTEMS INC /DE/ DATE OF NAME CHANGE: 19951214 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: ALLEN ROBERT W CENTRAL INDEX KEY: 0001027190 FILING VALUES: FORM TYPE: 5 SEC ACT: 1934 Act SEC FILE NUMBER: 000-03718 FILM NUMBER: 101021594 MAIL ADDRESS: STREET 1: PARK CITY GROUP,INC. STREET 2: 3160 PINEBROOK RD. CITY: PARK CITY STATE: UT ZIP: 84098 5 1 doc1.xml FORM 5 X0303 5 2010-06-30 0 0 0 0000050471 PARK CITY GROUP INC PCYG 0001027190 ALLEN ROBERT W 3160 PINEBROOK RD PARK CITY UT 84098 1 0 0 0 Common Stock 194865 D Common Stock 37314 I By Trust Series A Convertible Preferred Stock 10.00 2009-06-03 Common Stock 51637 15491 D Series A Convertible Preferred Stock 10.00 2009-06-03 Common Stock 51640 15492 I By Trust (Spouse) Common Stock Purchase Warrants 4.00 2007-06-05 2011-05-31 Common Stock 8928 8928 D Common Stock Purchase Warrants 4.00 2007-06-05 2011-05-31 Common Stock 8929 8929 I By Trust (Spouse) Series B Convertible Preferred Stock 10.00 2010-06-30 5 J 0 52301 4.00 A 2010-06-30 Common Stock 130752.5 52301 D The Series A Preferred Stock remains convertible so long as the shares remain issued and outstanding. The Series B Convertible Preferred Stock remains convertible so long as the shares remain issued and outstanding. Shares were issued upon conversion of certain debt of Park City Group, Inc. held by Mr. Allen. /s/ Robert W. Allen 2010-08-16 -----END PRIVACY-ENHANCED MESSAGE-----