0001019687-12-003518.txt : 20121001
0001019687-12-003518.hdr.sgml : 20121001
20121001165020
ACCESSION NUMBER: 0001019687-12-003518
CONFORMED SUBMISSION TYPE: 4
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20120928
FILED AS OF DATE: 20121001
DATE AS OF CHANGE: 20121001
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: Forkey Joseph Norman
CENTRAL INDEX KEY: 0001360197
FILING VALUES:
FORM TYPE: 4
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-10647
FILM NUMBER: 121120466
MAIL ADDRESS:
STREET 1: C/O PRECISION OPTICS CORPORATION INC
STREET 2: 22 EAST BROADWAY
CITY: GARDNER
STATE: MA
ZIP: 01440
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: PRECISION OPTICS Corp INC
CENTRAL INDEX KEY: 0000867840
STANDARD INDUSTRIAL CLASSIFICATION: ELECTROMEDICAL & ELECTROTHERAPEUTIC APPARATUS [3845]
IRS NUMBER: 042795294
STATE OF INCORPORATION: MA
FISCAL YEAR END: 0630
BUSINESS ADDRESS:
STREET 1: 22 EAST BROADWAY
CITY: GARDNER
STATE: MA
ZIP: 01440
BUSINESS PHONE: 978-630-1800
MAIL ADDRESS:
STREET 1: 22 EAST BROADWAY
CITY: GARDNER
STATE: MA
ZIP: 01440
FORMER COMPANY:
FORMER CONFORMED NAME: PRECISION OPTICS CORPORATION INC
DATE OF NAME CHANGE: 19930328
FORMER COMPANY:
FORMER CONFORMED NAME: PRECISION OPTICS CORP INC
DATE OF NAME CHANGE: 19600201
4
1
forkey_f4-092612.xml
FORM 4
X0306
4
2012-09-28
0
0000867840
PRECISION OPTICS Corp INC
PEYE
0001360197
Forkey Joseph Norman
PRECISION OPTICS CORPORATION, INC.
22 EAST BROADWAY
GARDNER
MA
01440
1
1
0
0
Chief Executive Officer
Common Stock, $0.01 par value
2012-09-28
4
P
0
22223
0.90
A
33620
D
Warrants
1.25
2012-09-28
4
P
0
15557
0.90
A
2012-09-28
2017-09-28
Common Stock
15557
15557
D
The 22,223 shares of common stock and warrants to purchase 15,557 shares of common stock were purchased in a private placement at a price of $0.90 per unit. Each unit consisted of one share of common stock and 70% warrant coverage.
Mr. Forkey beneficially owns shares of common stock through joint ownership with his wife, Heather C. Forkey, with whom he shares voting and dispositive control.
/s/ Jack P. Dreimiller as attorney in fact
2012-10-01