-----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, O3NT1+Ek3DzBlfczujtJk0UG2qK7d29jpLTtAvm5x3U30ZuP1HzEgfQ72JOvHI1P 8QmUehGm8e0PUxXY+sY0aA== 0001010521-98-000187.txt : 19980220 0001010521-98-000187.hdr.sgml : 19980220 ACCESSION NUMBER: 0001010521-98-000187 CONFORMED SUBMISSION TYPE: 3/A PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19970130 FILED AS OF DATE: 19980219 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: PHILLIPS R H INC CENTRAL INDEX KEY: 0000925712 STANDARD INDUSTRIAL CLASSIFICATION: BEVERAGES [2080] IRS NUMBER: 680313739 STATE OF INCORPORATION: CA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A SEC ACT: SEC FILE NUMBER: 000-26276 FILM NUMBER: 98545593 BUSINESS ADDRESS: STREET 1: 26836 COUNTY RD STREET 2: SUITE 12A CITY: ESPARTO STATE: CA ZIP: 95627 BUSINESS PHONE: 9166623215 MAIL ADDRESS: STREET 1: 26836 COUNTY ROAD STREET 2: SUITE 12A CITY: ESPARTO STATE: CA ZIP: 95627 COMPANY DATA: COMPANY CONFORMED NAME: HANCOCK JOHN MUTUAL LIFE INSURANCE CO / MA CENTRAL INDEX KEY: 0000917406 STANDARD INDUSTRIAL CLASSIFICATION: UNKNOWN SIC - 0000 [0000] OWNER IRS NUMBER: 041414660 STATE OF INCORPORATION: MA FISCAL YEAR END: 1231 FILING VALUES: FORM TYPE: 3/A BUSINESS ADDRESS: STREET 1: CORPORATE LAW DIVISION T-55 STREET 2: P O BOX 111 CITY: BOSTON STATE: MA ZIP: 02117 BUSINESS PHONE: 6175726000 MAIL ADDRESS: STREET 1: CORPORATE LAW DIVISION T-55 STREET 2: P O BOX 111 CITY: BOSTON STATE: MA ZIP: 02117 3/A 1 R. H. PHILLIPS, INC. ------------------------------ OMB APPROVAL ------------------------------ OMB Number 3235-0104 Expires: April 30, 1998 Estimated average burden hours per response ....... 0.5 ------------------------------ U.S. SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 FORM 3 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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 John Hancock Mutual Life Insurance Company - -------------------------------------------------------------------------------- (Last) (First) (Middle) P.O. Box 111 - -------------------------------------------------------------------------------- (Street) Boston, MA 02117 - -------------------------------------------------------------------------------- (City) (State) (Zip) ================================================================================ 2. Date of Event Requiring Statement (Month/Day/Year) 1/26/97 ================================================================================ 3. IRS or Social Security Number of Reporting Person (Voluntary) 04-1414660 ================================================================================ 4. Issuer Name and Ticker or Trading Symbol R. H. Phillips, Inc. ("RHPS") ================================================================================ 5 Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [ X ] 10% Owner [ ] Officer (give title below) [ ] Other (specify below) -------------------------------------------------------------------- ================================================================================ 6. If Amendment, Date of Original (Month/Year) 1/30/97 ================================================================================ Table I -- Non-Derivative Securities Beneficially Owned ================================================================================
3. Ownership Form: 2. Amount of Securities Direct (D) or 1. Title of Security Beneficially Owned Indirect (I) 4. Nature of Indirect Beneficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr.5) - ------------------------------------------------------------------------------------------------------------------------------------ 12% Senior Redeemable Preferred Stock (non-voting) 500,000 D N/A - ------------------------------------------------------------------------------------------------------------------------------------ Common Stock 37,500 D N/A - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) FORM 3 (continued) Table II -- Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) ================================================================================
5. Owner- 3. Title and Amount of Securities ship Underlying Derivative Security Form of 2. Date Exercisable (Instr. 4) Derivative and Expiration Date --------------------------------- 4. Conver- Security: (Month/Day/Year) Amount sion or Direct 7. Nature of ---------------------- or Exercise (D) or Indirect Date Expira- Number Price of Indirect Beneficial 1. Title of Security Exer- tion of Derivative (I) Ownership (Instr. 4) cisable Date Title Shares Security (Instr.5) (Instr. 5) - ------------------------------------------------------------------------------------------------------------------------------------ Warrants for Common Stock(1) 3/27/97 3/27/97 Common Stock 1,346,788 $4 per share(2) D N/A - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ ====================================================================================================================================
Explanation of Responses: (1) The Warrants entitle the Reporting Person to purchase an equivalent number of shares of the Issuer's common stock. (2) The number and price of the securities issuable upon exercise shall be adjusted pursuant to certain anti-dilution provisions. John Hancock Mutual Life Insurance Company By: /s/ M. M. Stapleton February 17, 1998 --------------------------------------------- ----------------------- **Signature of Reporting Person Date ** 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. -----END PRIVACY-ENHANCED MESSAGE-----