-----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, QdHMZPpdLLd7zN6uz4E4Bw+q1zsgWxLRPAg+CO5VZhDNhm2IO55i1tY5e7F13iMN BJRjLMkNSU0stv2RKcv+zw== 0001179110-03-012528.txt : 20031215 0001179110-03-012528.hdr.sgml : 20031215 20031215095255 ACCESSION NUMBER: 0001179110-03-012528 CONFORMED SUBMISSION TYPE: 4 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 20031015 FILED AS OF DATE: 20031215 ISSUER: COMPANY DATA: COMPANY CONFORMED NAME: WITS BASIN PRECIOUS MINERALS INC CENTRAL INDEX KEY: 0000912875 STANDARD INDUSTRIAL CLASSIFICATION: GOLD & SILVER ORES [1040] IRS NUMBER: 841236619 STATE OF INCORPORATION: MN FISCAL YEAR END: 1231 BUSINESS ADDRESS: STREET 1: 800 NICOLLET MALL STREET 2: SUITE 2690 CITY: MINNEAPOLIS STATE: MN ZIP: 55402 BUSINESS PHONE: (612)664-0570 MAIL ADDRESS: STREET 1: 800 NICOLLET MALL STREET 2: SUITE 2690 CITY: MINNEAPOLIS STATE: MN ZIP: 55402 FORMER COMPANY: FORMER CONFORMED NAME: ACTIVE IQ TECHNOLOGIES INC DATE OF NAME CHANGE: 20010702 FORMER COMPANY: FORMER CONFORMED NAME: METEOR INDUSTRIES INC DATE OF NAME CHANGE: 19960313 REPORTING-OWNER: OWNER DATA: COMPANY CONFORMED NAME: MILLS WAYNE WILLIAM CENTRAL INDEX KEY: 0000930294 FILING VALUES: FORM TYPE: 4 SEC ACT: 1934 Act SEC FILE NUMBER: 001-12401 FILM NUMBER: 031053188 BUSINESS ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITE 29D CITY: PLYMOUTH STATE: MN ZIP: 55441 BUSINESS PHONE: 6125423737 MAIL ADDRESS: STREET 1: 5500 WAYZATA BLVD STREET 2: SUITW 29D CITY: PLYMOUTH STATE: MN ZIP: 55441 4 1 edgar.xml FORM 4 - X0201 4 2003-10-15 1 0000912875 WITS BASIN PRECIOUS MINERALS INC WITM 0000930294 MILLS WAYNE WILLIAM 5020 BLAKE ROAD S. EDINA MN 55436 0 0 1 0 Common Stock, $.01 par value 1280900 D Common Stock, $.01 par value 30000 I By Sea Spray, Ltd. Common Stock, $.01 par value 368500 I By Blake Capital LLC Common Stock, $.01 par value 150000 I By Spouse Warrants 5.5 2003-10-15 5 G 0 E 90000 0 D 2001-01-31 2006-01-31 Common Stock, $.01 par value 90000 0 D Warrants 5.5 2003-10-15 5 G 0 E 208334 0 D 2001-04-30 2006-04-30 Common Stock, $.01 par value 208334 0 D Warrant 2.5 2000-05-15 2005-05-15 Common Stock, $.01 par value 100000 100000 D Stock Option .4 2003-06-16 2010-06-16 Common Stock, $.01 par value 100000 100000 D Warrants 7.5 2004-05-31 Common Stock, $.01 par value 15000 15000 I By Blake Capital, LLC Warrants 3 2007-03-29 Common Stock, $.01 par value 25000 25000 I By Blake Capital, LLC Warrants 3 2003-10-15 5 G 0 E 375000 0 D 2001-05-01 2006-05-01 Common Stock, $.01 par value 375000 125000 I By Blake Capital LLC Warrants 3 2003-10-15 5 G 0 E 250000 0 A 2001-05-01 2006-05-01 Common Stock, $.01 par value 250000 250000 I By Trust for benefit of Reporting Persons Children A foreign corporation of which the Reporting Person is the sole shareholder. A limited liability company, of which the Reporting Person is the sole shareholder. Exercisable immediately upon issuance. The Reporting Person is not a trustee of this trust and disclaims beneficial ownership of these shares. /s/ Wayne W. Mills 2003-12-15 -----END PRIVACY-ENHANCED MESSAGE-----