0001144204-12-001291.txt : 20120109
0001144204-12-001291.hdr.sgml : 20120109
20120109144731
ACCESSION NUMBER: 0001144204-12-001291
CONFORMED SUBMISSION TYPE: 4/A
PUBLIC DOCUMENT COUNT: 1
CONFORMED PERIOD OF REPORT: 20110914
FILED AS OF DATE: 20120109
DATE AS OF CHANGE: 20120109
REPORTING-OWNER:
OWNER DATA:
COMPANY CONFORMED NAME: PALAMAND SURY RAO
CENTRAL INDEX KEY: 0001240350
FILING VALUES:
FORM TYPE: 4/A
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-13636
FILM NUMBER: 12517268
MAIL ADDRESS:
STREET 1: 5002 AMBERWAY DRIVE
CITY: ST. LOUIS
STATE: MO
ZIP: 63128
ISSUER:
COMPANY DATA:
COMPANY CONFORMED NAME: MENDOCINO BREWING CO INC
CENTRAL INDEX KEY: 0000919134
STANDARD INDUSTRIAL CLASSIFICATION: MALT BEVERAGES [2082]
IRS NUMBER: 680318293
STATE OF INCORPORATION: CA
FISCAL YEAR END: 1231
BUSINESS ADDRESS:
STREET 1: 1601 AIRPORT ROAD
CITY: UKIAH,
STATE: CA
ZIP: 95482
BUSINESS PHONE: 7077441015
MAIL ADDRESS:
STREET 1: 1601 AIRPORT ROAD
CITY: UKIAH,
STATE: CA
ZIP: 95482
4/A
1
v245015_4a.xml
OWNERSHIP DOCUMENT
X0304
4/A
2011-09-14
2011-09-16
0
0000919134
MENDOCINO BREWING CO INC
MENB
0001240350
PALAMAND SURY RAO
5002 AMBERWAY DRIVE
ST. LOUIS
MO
63128
1
0
0
0
Common Stock
2011-09-14
4
G
0
29032
0
A
332110
I
By trust
Shares issued as compensation issued to Sury Rao Palamand for attendance at Board meetings in 2009 pursuant to the terms of the Issuer's Directors' Compensation Plan, as amended, and gifted by Mr. Palamand to a trust for the benefit of his immediate family and lineal descendants.
Although previously filed Form 4s indicated that these shares were held directly by Sury Rao Palamand, they are held by a revocable trust for the benefit of his immediate family and lineal descendants. Mr. Palamand serves as trustee.
/s/ Sury Rao Palamand
2012-01-07