-----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, NizPlTQ3TA3k66D4j951/8O4DftbU3MAIbHmALuQw+bhprq1rEg7tcdqukvexmHP 5HJWwMP4bMqtwYyCEJT7kA== 0000950152-96-002992.txt : 19960629 0000950152-96-002992.hdr.sgml : 19960629 ACCESSION NUMBER: 0000950152-96-002992 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 FILED AS OF DATE: 19960617 DATE AS OF CHANGE: 19960627 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MOUNTASIA ENTERTAINMENT INTERNATIONAL INC CENTRAL INDEX KEY: 0000912027 STANDARD INDUSTRIAL CLASSIFICATION: 7900 IRS NUMBER: 581949379 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11709 FILM NUMBER: 96582349 BUSINESS ADDRESS: STREET 1: 5895 WINDWARD PKWY STREET 2: STE 220 CITY: ALPHARETTA STATE: GA ZIP: 30202 BUSINESS PHONE: 4044426640 MAIL ADDRESS: STREET 1: 5895 WINDWARD PARKWAY SUITE 220 CITY: ALPHARETTA STATE: GA ZIP: 30202 COMPANY DATA: COMPANY CONFORMED NAME: MEI HOLDINGS L P CENTRAL INDEX KEY: 0001016939 STANDARD INDUSTRIAL CLASSIFICATION: OWNER STATE OF INCORPORATION: DE FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: 4200 TEXAS COMMERCE TOWER STREET 2: 2200 ROSS AVE CITY: DALLAS STATE: TX ZIP: 75201 BUSINESS PHONE: 2142204900 MAIL ADDRESS: STREET 1: 4200 TEXAS COMMERCE TOWER WEST STREET 2: 2200 ROSS AVE CITY: DALLAS STATE: TX ZIP: 75201 3 1 MEI HOLDINGS/MOUNTASIA ENTERTAINMENT FORM 3 1
------------------------- FORM 3 OMB Approval U.S. SECURITIES AND EXCHANGE COMMISSION ------------------------- WASHINGTON, D.C. 20549 OMB Number 3235-0104 Expires: May 31, 1994 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Estimated average burden hours per response... 0.5 Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - - ------------------------------------------------------------------------------------------------------------------------------------ 1. Name and Address of Reporting Person| 2. Date of Event Re- | 4. Issuer Name and Ticker or Trading Symbol | quiring Statement | MEI HOLDINGS, L.P. | (Month/Day/Year) | MOUNTASIA ENTERTAINMENT INTERNATIONAL, INC. (FUNN) - - ---------------------------------------| |------------------------------------------------------------------ (Last) (First) (Middle) | 06-06-96 | 5. Relationship of Reporting | 6. If Amendment, Date of 2200 ROSS AVENUE |-------------------------| Person to Issuer | Original SUITE 4200 WEST | 3. IRS or Social | (Check all applicable) | (Month/Day/Year) - - ---------------------------------------| Security Number | _____ Director __X__ 10% Owner| (Street) | of Reporting | _____ Officer (give title below) | | Person (Voluntary) | _____ Other (specify below) | | | | DALLAS TEXAS 75201 | | ______________________ | - - ------------------------------------------------------------------------------------------------------------------------------------ (City) (State) (Zip) | TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED | - - ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Security | 2. Amount of Securities | 3. Ownership | 4. Nature of Indirect Beneficial (Instr. 4) | Beneficially Owned* | Form: Direct | Ownership (Instr. 5) | (Instr. 4) | (D) or Indirect | | | (I) (Instr. 5) | - - ------------------------------------------------------------------------------------------------------------------------------------ COMMON STOCK, NO PAR VALUE | 10,819,666 | D | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ | | | - - ------------------------------------------------------------------------------------------------------------------------------------ Reminder: Report on a separate line for each class of securities beneficially owned, directly or indirectly. (Over) * Represents shares of Common Stock issuable to MEI Holdings, L.P. pursuant to the Investment Agreement between the issuer and MEI Holdings, L.P., dated June 5, 1996 and incorporated herein by reference to the Schedule 13D dated June 17, 1996 filed by MEI Holdings, L.P. with respect to the issuer. Pursuant to such Investment Agreement MEI Holdings, L.P. will acquire 44.44% of the issuer's Common Stock to be outstanding immediately after the closing thereunder. The actual number of shares acquired may be more or less than the above amount depending on the number of the issuer's shares outstanding at the time of such closing. (PRINT OR TYPE RESPONSES)
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FORM 3 (CONTINUED) TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) - - ------------------------------------------------------------------------------------------------------------------------------------ 1.Title of Derivative Security | 2.Date Exer- | 3.Title and Amount of Securities | 4.Conver- | 5. Owner- | 6. Nature of Indirect (Instr. 4) | cisable and | Underlying Derivative Security | sion or | ship | Beneficial | Expiration | (Instr. 4) | Exercise | Form of | Ownership | Date | | Price of | Deriv- | (Instr. 5) | (Month/Day/ | | Deri- | ative | | Year) | | vative | Security:| |--------------------------------------------------| Security | Direct | | Date | Expir-| | Amount | | (D) or | | Exerc-| ation | Title | or | | Indirect | | isable| Date | | Number | | (I) | | | | | of | | (Instr. 5) | | | | | Shares | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- COMMON STOCK | * | N/A | Warrant | * | * | D | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - -------------------------------|-------|-------|-------------------------|--------|-----------|-------------|----------------------- | | | | | | | - - ------------------------------------------------------------------------------------------------------------------------------------ Explanation of Responses: * Pursuant to the Investment Agreement described above MEI HOLDINGS, L.P. the warrant will allow MEI Holdings, L.P. to acquire (without payment of further consideration) additional By: MEI GenPar, L.P. Common Stock to adjust for any post-closing issuances of Its general partner Common Stock under existing commitments, below 130% of the per-share investment price as of the closing. By: HH GenPar Partners Its general partner By: Hampstead Associates, Inc. Its managing general partner By /s/ DANIEL A. DECKER June 17, 1996 -------------------------------- ----------------- **Signature of Reporting Person Date Daniel A. Decker Executive Vice President ** Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, See Instruction 6 for procedure. Page 2
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