-----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, IH6G6/89earAiF9ItH6eLnXysxXRUlRnCgpQSf3S36qBZgdlMJOiDioN5b17FO7F BEvTkV+Xe/4p+Xkh2SH3XA== 0001005477-97-000199.txt : 19970221 0001005477-97-000199.hdr.sgml : 19970221 ACCESSION NUMBER: 0001005477-97-000199 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19970101 FILED AS OF DATE: 19970210 SROS: NONE SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: MOUNTASIA ENTERTAINMENT INTERNATIONAL INC CENTRAL INDEX KEY: 0000912027 STANDARD INDUSTRIAL CLASSIFICATION: SERVICES-MISCELLANEOUS AMUSEMENT & RECREATION [7990] IRS NUMBER: 581949379 STATE OF INCORPORATION: GA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-11709 FILM NUMBER: 97523180 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: 4 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 4 1 FORM 4 FORM 4 U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 4 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP 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 [ ] Check this box if no longer subject of Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). ================================================================================ 1. Name and Address of Reporting Person MEI Holdings, L.P. - -------------------------------------------------------------------------------- (Last) (First) (Middle) 2200 Ross Avenue, Suite 4200 West - -------------------------------------------------------------------------------- (Street) Dallas, Texas 75201 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Issuer Name and Ticker or Trading Symbol Mountasia Entertainment International, Inc. (MBE) ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) ================================================================================ 4. Statement for Month/Year 02/97 ================================================================================ 5. If Amendment, Date of Original (Month/Year) ================================================================================ 6. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ X ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) ______________________________________________________________________ ================================================================================ Table I -- Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned ================================================================================
6. 4. 5. Owner- Securities Acquired (A) or Amount of ship 3. Disposed of (D) Securities Form: 7. Transaction (Instr. 3, 4 and 5) Beneficially Direct Nature of 2. Code ------------------------------- Owned at End (D) or Indirect 1. Transaction (Instr. 8) (A) of Month Indirect Beneficial Title of Security Date ------------ Amount or Price (Instr. 3 (I) Ownership (Instr. 3) (mm/dd/yy) Code V (D) and 4) (Instr.4) (Instr. 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 01/15/97 J* 7,802,435 A $3.50 I - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 01/31/97 J** 384,603 A $ 0 14,419,337 I - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly * Represents shares acquired in a tender offer commenced by MEI Holdings, L.P. ("MEI Holdings") on November 14, 1996 which expired on January 14, 1997 (the "Tender Offer"). MEI Holdings is required to vote the shares of Common Stock acquired in the Tender Offer (to the extent that the Common Stock beneficially owned by MEI Holdings and its affiliates exceed 49.9% of all outstanding shares of Common Stock at the time in question) in the same proportion as the shares of Common Stock held by persons other than MEI Holdings are voted. ** Represents shares issued under the Warrant granted to MEI Holdings on August 28, 1996 (the "Warrant") which provides, as anti-dilution protection, for the issuance to MEI Holdings, without the payment of additional consideration, of shares of Common Stock or Series F Preferred Stock of the issuer upon the conversion, redemption or repayment of certain convertible securities of the issuer. FORM 4 (continued) Table II -- Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
9. 10. Number Owner- of ship 2. Deriv- of Conver- 5. 7. ative Deriv- 11. sion Number of Title and Amount Secur- ative Nature of Derivative 6. of Underlying 8. ities Secur- of Exer- 4. Securities Date Securities Price Bene- ity: In- cise 3. Trans- Acquired (A) Exercisable and (Instr. 3 and 4) of ficially Direct direct Price Trans- action or Disposed Expiration Date ---------------- Deriv- Owned (D) or Bene- 1. of action Code of(D) (Month/Day/Year) Amount ative at End In- ficial Title of Deriv- Date (Instr. (Instr. 3, ---------------- or Secur- of direct Owner- Derivative ative (Month/ 8) 4 and 5) Date Expira- Number ity Month (I) ship Security Secur- Day/ ------ ------------ Exer- tion of (Instr. (Instr. (Instr. (Instr. (Instr. 3) ity Year) Code V (A) (D) cisable Date Title Shares 5) 4) 4) 4) - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ Series G Preferred Stock $ 0 1/15/97 J (A) *** *** Common 2,135,513 $22.60 2,135,513 213,551 Stock I - ------------------------------------------------------------------------------------------------------------------------------------ Series F Preferred Stock $ 0 1/15/97 J (A) **** **** Common 17,272,991 ***** 17,272,991 1,727,299 Stock I - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: *** Series G Preferred Stock is economically equivalent to ten shares of Common Stock, is nonvoting except in certain limited circumstances and is convertible into Common Stock at a rate of 10 shares of Common Stock per share of Series G Preferred Stock upon shareholder approval of such conversion. Represents shares issued in consideration of MEI Holdings' funding of the issuer's redemption of its $4.5 million 10% Convertible Subordinated Debentures. The purchase price per share of Series G Preferred Stock is subject to upward adjustment in certain circumstances. **** Series F Preferred Stock is economically equivalent to ten shares of Common Stock, is nonvoting except in certain limited circumstances and is convertible into Common Stock at a rate of 10 shares of Common Stock per share of Series F Preferred Stock upon shareholder approval of such conversion. Represents (a) 447,752 shares issued upon MEI Holdings' conversion of certain debentures of the issuer having an aggregate principal amount of $15.6 million that were acquired by MEI Holdings in the Tender Offer, (b) 377,773 shares that MEI Holdings believes are issuable pursuant to the Warrant upon conversion of such debentures and other convertible securities of the issuer and pursuant to certain valuation adjustments provided for in the Investment Agreement between the issuer and MEI Holdings entered into in June, 1996 (the "Investment Agreement") and (c) the estimated 901,774 shares issuable to MEI Holdings following the issuer's exercise of its right, under the Investment Agreement, to require MEI Holdings to invest $22.7 million. The number of shares issued under the Warrant and for the $22.7 million investment are subject to adjustment upon the occurrence of certain events outside MEI Holdings' control. ***** The purchase price for the 447,752 shares referred to in clause (a) of the previous footnote was $35.00 per share and for the 901,774 shares in clause (c) (which is subject to adjustment) was $2.52 per share (or $2.14 per share if the shareholder approval referred to above is not obtained). The 377,773 shares referred to in clause (b) were acquired for no additional consideration. MEI Holdings, L.P. By: MEI GenPar, L.P. Its General Partner By: HH GenPar Partners Its General Partner By: Hampstead Associates, Inc. Its Managing General Partner February 10, 1997 - --------------------------------------------- ----------------------- **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 procedures. -----END PRIVACY-ENHANCED MESSAGE-----