-----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, MW8JJEDyJ63PXtLRamN5RRlpl2cqYdARWt19LKORHQwrmMsc861Wo3HGbB/7IG85 Q+2IPZ9YPgz+/cIY/st+aw== /in/edgar/work/20000609/0001068238-00-000218/0001068238-00-000218.txt : 20000919 0001068238-00-000218.hdr.sgml : 20000919 ACCESSION NUMBER: 0001068238-00-000218 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20000531 FILED AS OF DATE: 20000609 SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MICROTEL INTERNATIONAL INC CENTRAL INDEX KEY: 0000854852 STANDARD INDUSTRIAL CLASSIFICATION: [3825 ] IRS NUMBER: 770226211 STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: SEC FILE NUMBER: 001-10346 FILM NUMBER: 652144 BUSINESS ADDRESS: STREET 1: 9485 HAVEN AVENUE STREET 2: STE 100 CITY: ONTARIO STATE: CA ZIP: 91730 BUSINESS PHONE: 9092972699 MAIL ADDRESS: STREET 1: 9485 HAVEN AVENUE STREET 2: STE 100 CITY: ONTARIO STATE: CA ZIP: 91730 FORMER COMPANY: FORMER CONFORMED NAME: CXR CORP DATE OF NAME CHANGE: 19920703 COMPANY DATA: COMPANY CONFORMED NAME: MACKENZIE ALAN S JR CENTRAL INDEX KEY: 0001098051 STANDARD INDUSTRIAL CLASSIFICATION: [ ]OWNER FILING VALUES: FORM TYPE: 4 BUSINESS ADDRESS: STREET 1: C/O ORBIT II PARTNERS LP STREET 2: 2 RECTOR STREET 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10006 BUSINESS PHONE: 2122331340 MAIL ADDRESS: STREET 1: C/O ORBIT II PARTNERS LP STREET 2: 2 RECTOR STREET 16TH FLOOR CITY: NEW YORK STATE: NY ZIP: 10006 4 1 0001.txt STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
---------------------------- UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB APPROVAL ---------------------------- - - -------- Washington, D.C. 20549 OMB Number 3235-0287 FORM 4 Expires: December 31, 2001 - - -------- STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Estimated average burden hours per response. . . .0.5 ---------------------------- [ ] Check this box if no Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the longer subject to Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). - - ---------------------------------------------------------------------------------------------------------------------------------- 1. Name and Address of Reporting | 2. Issuer Name and Ticker or Trading Symbol | 6. Relationship of Reporting Person(s) to Issuer Person* | | (Check all applicable) | | | | [ ] Director [X] 10% Owner MacKenzie Alan S. |MicroTel International, Inc. OTC.BB: "MCTL.OB"| [ ] Officer (give [ ] Other (specify - - ------------------------------------------------------------------------------| title below) below) (Last) (First) (Middle) | 3. IRS or Social Security| 4. Statement for | | Number of Reporting | Month/Year | | Person (Voluntary) | | c/o Orbit II Partners, L.P. | | 5/00 | ---------------------------------------- 2 Rector Street, 16th Floor | |----------------------------------------------------------------------- - - -------------------------------| | 5.If Amendment, | 7. Individual or Joint/Group Filing (Street) | | Date of Original| (Check Applicable Line) | | (Month/Year) | [X] Form filed by One Reporting Person New York New York 10006 | | | [ ] Filed by More than One Reporting Person - - ---------------------------------------------------------------------------------------------------------------------------------- (City) (State) Zip) | Table 1 - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned - - ---------------------------------------------------------------------------------------------------------------------------------- 1. Title of Security | 2. Trans-| 3. Trans- | 4. Securities Acquired | 5. Amount of | 6. Owner- |7. Nature (Instr. 3) | action| action | (A) or Disposed of (D) | Securities | ship | of In- | Date | Code | (Instr.3, 4 and 5) | Beneficially| Form: | direct | (Month/| (Instr. 8)| | Owned at | Direct | Beneficial | Day/ |----------------------------------------- | End of Month| (D) or | Owner- | Year) | | | | (A) or | | | Indirect | ship | | Code | V | Amount | (D) | Price | (Instr.3 | (I) | | | | | | | | and 4) | (Instr.4)| (Instr.4) - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | Common Stock | 5/11/00 | S | | 4,800 | (D) |$0.71875| | (I) | (1) - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | Common Stock | | | | | | | 750,900 | (I) | (1) - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | - - ---------------------------------------------------------------------------------------------------------------------------------- Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (1) These securities are owned by Orbit II Partners, L.P., a limited partnership formed under the laws of the State of Delaware ("Orbit II"). The Reporting Person is a Managing General Partner of Orbit II. (Over) FORM 4 (continued) Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) - - ---------------------------------------------------------------------------------------------------------------------------------- 1.Title of |2.Conver- |3.Transac-|4.Transac-|5.Number |6. Date Exer-|7.Title and |8.Price |9.Number |10.Owner- |11.Nature Derivative | sion or | tion | tion | of Der- | cisable | Amount of | of | of Deriv-| ship | of Security | Exercise| Date | Code | ivative | and Exp- | Underlying | Deriv-| ative | Form of | Indirect (Instr. 3) | Price of| | (Instr.8)| Securi- | iration | Securities | ative | Secur- | Deriv- | Benefi- | Deriv- | (Month/ | | ities | Date | (Instr.3 | Secur-| ities | ative | cial | ative | Day/ | | Acquired | (Month/ | and 4) | ity | Bene- | Security:| Owner- | Security| Year) | | (A) or | Day/Year) | | (Instr.| ficially | Direct | ship | | | | Disposed | | | 5) | Owned | (D) or | (Instr.4) | | | | of(D) |-----------------------------| | at End | Indirect | | | | | (Instr.3,|Date |Expir|Title|Amount or| | of | (I) | | | | | 4 and 5):|Exer- |ation| |Number of| | Month | (Instr.4)| | | |----------------------|cisable|Date | |Shares | | (Instr.4) | | | | | Code | V | (A) | (D) | | | | | | | | - - -------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | |Common| | | | | Warrants | $0.25 | | | | | |12/23/ |12/23/|Stock | 172,500| | 172,500 | (I) | (2) | | | | | | | 99 | 02 | | | | | | - - ---------------------------------------------------------------------------------------------------------------------------------- Series A | | | | | |12/23/ |5/22/ |Common| | | | | Preferred | (3) | | | | | 99 | 03(3)|Stock |1,743,285| | 34.5(3) | (I) | (2) Stock | | | - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | |01/01/ |6/30/ |Common| | | | | Warrant | $0.75 | | | | | | 99 | 00 |Stock | 150,000| | 150,000 | (I) | (4) - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | - - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | - - ---------------------------------------------------------------------------------------------------------------------------------- /s/ Alan S. MacKenzie, Jr. 6/6/00 ---------------------------------- ----------------- Alan S. MacKenzie, Jr. Date **Signature of Reporting Person Explanation of Responses: **Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). (2) These securities are owned by Orbit II. The Reporting Person is Managing General Partner of Orbit II. (3) Each share of Series A Preferred Stock is convertible into 50,530 shares of Common Stock prior to May 22, 2003. On May 22, 2003, the Issuer is required to redeem each outstanding share of Series A Preferred Stock for $11,500.00. (4) These securities are owned by OTAF, LLC, a limited liability company formed under the laws of the State of New York ("OTAF"). The Reporting Person is a Administrative Member of OTAF. Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, See Instruction 6 for procedure. Potential persons who are to respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. Page 2
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