-----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, QOOAmi3xxgBmxHoSvREZpC+tqnYFCnCnXXGaDFteQUwkxCPIXB9U0aD7YAD1/WLF oVqDC3l2CpCTSuEinx4yXA== 0001144204-04-022696.txt : 20041223 0001144204-04-022696.hdr.sgml : 20041223 20041223182246 ACCESSION NUMBER: 0001144204-04-022696 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20040617 FILED AS OF DATE: 20041223 DATE AS OF CHANGE: 20041223 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: DURHAM TIMOTHY S CENTRAL INDEX KEY: 0001131157 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 000-15284 FILM NUMBER: 041225350 BUSINESS ADDRESS: BUSINESS PHONE: 3172374122 MAIL ADDRESS: STREET 1: 111 MONUMENT CIRCLE STREET 2: SUITE 3680 CITY: INDIANAPOLIS STATE: IN ZIP: 46204 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: NATIONAL LAMPOON INC CENTRAL INDEX KEY: 0000798078 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MOTION PICTURE & VIDEO TAPE PRODUCTION [7812] IRS NUMBER: 954053296 STATE OF INCORPORATION: CA FISCAL YEAR END: 0731 BUSINESS ADDRESS: STREET 1: 10850 WILSHIRE BLVD STE 1000 CITY: LOS ANGELES STATE: CA ZIP: 90024 BUSINESS PHONE: 3104745252 MAIL ADDRESS: STREET 1: 10850 WILSHIRE BLVD STREET 2: SUITE 1000 CITY: LOS ANGELES STATE: CA ZIP: 90024 FORMER COMPANY: FORMER CONFORMED NAME: J2 COMMUNICATIONS /CA/ DATE OF NAME CHANGE: 19920703 FORMER COMPANY: FORMER CONFORMED NAME: J2 TELECOMMUNICATIONS DATE OF NAME CHANGE: 19890731 FORMER COMPANY: FORMER CONFORMED NAME: J2 COMMUNICATIONS DATE OF NAME CHANGE: 19880308 4 1 v010327_ex.xml X0202 4 2004-06-17 0 0000798078 NATIONAL LAMPOON INC NLPN 0001131157 DURHAM TIMOTHY S 10850 WILSHIRE BLVD. SUITE 1000 LOS ANGELES CA 90024 1 0 1 0 Director Stock Option (right to buy) 1.60 2004-06-17 4 A 0 15000 A 2004-06-17 2014-06-16 Common Stock 15000 15000 D Series C Convertible Preferred Stock 2004-10-25 4 P 0 28169 A 2004-10-25 Common Stock 563380 28169 D Warrant for Common Shares 1.775 2004-10-25 4 P 0 28169 A 2004-10-25 Common Stock 281690 28169 D The option vested with respect to all shares on the date of grant. Mr. Durham's grant was for 7,500 shares of common stock at an exercise price of $3.20 per share. As a result of the Company's two for one stock split on September 15, 2004, the number of shares underlying the grant was doubled to 15,000 and the exercise price was halved to $1.60. On October 25, 2004, the Reporting Person converted $1,000,000 of loans he had made to the Issuer into 28,169 shares of Series C Convertible Preferred Stock. Each share of Series C Convertible Preferred Stock is convertible into 20 shares of common stock, and one warrant to purchase 10 shares of commmon stock at $1.775 per share. N/A /s/ Timothy S. Durham 2004-12-22 -----END PRIVACY-ENHANCED MESSAGE-----