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 Marino David N. |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. | | 6/00 | ---------------------------------------- 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 | 06/06/00 | S | | 10,000 | (D) | $0.75 | | (I) | (1) - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | Common Stock | 06/28/00 | P | | 7,500 | (A) |$0.53125| | (I) | (1) - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | Common Stock | 06/29/00 | P | | 10,000 | (A) |$0.53125| | (I) | (1) - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | Common Stock | | | | | | | 2,674,185 | (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 | $1.00 | 6/20/00 | J(2) | | (2) | |06/20/ |11/25/|Stock | 43,125 | | 43,125 | (I) | (3) | | | | | | | 00 | 01 | | | | | | - ---------------------------------------------------------------------------------------------------------------------------------- Series A | | | | | | |12/23/ |5/22/ |Common| | | | | Preferred | (4) | 6/20/00 | C | | |34.5 | 99 |03(4) |Stock |1,743,285| | | (I) | (3) Stock | | | | | |(4) | | | | | | | | - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | |12/23/ |12/23/|Common| | | | | Warrant | $0.25 | 6/20/00 | X | | | (5) | 99 | 02 |Stock | 172,500| | | (I) | (3) - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | |01/01/ |6/30/ |Common| | | | | Warrant | $0.75 | 6/30/00 | J(6) | | | (6) | 99 | 00 |Stock | 150,000| | | (I) | (6) - ---------------------------------------------------------------------------------------------------------------------------------- | | | | | | | | | | | | | | | | | | | | | | | | | | | | - ---------------------------------------------------------------------------------------------------------------------------------- /s/ David N. Marino 7/6/00 ---------------------------------- ----------------- David N. Marino 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) Orbit II acquired from the Issuer warrants to purchase 43,125 shares of Common Stock as consideration for Orbit II's agreement to exercise certain warrants owned by Orbit II Partners. See note (3) below. (3) These securities were owned by Orbit II. The Reporting Person is a Managing General Partner of Orbit II. (4) Each share of Series A Preferred Stock was converted into 50,530 shares of Common Stock (or an aggregate of 1,743,285 shares of Common Stock) pursuant to the terms of the Series A Preferred Stock. (5) Orbit II exercised warrants to purchase 172,500 shares of Common Stock at an exercise price equal to $0.25 per share. (6) Warrants to purchase 150,000 shares of Common Stock expired unexercised. These warrants were owned by OTAF, LLC, a limited liability company ("OTAF"). The Reporting Person is an 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