SEC Form 4
FORM 4 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
1. Name and Address of Reporting Person*
MALLYA VIJAY

(Last) (First) (Middle)
2400 BRIDGEWAY
SUITE 290

(Street)
SAUSALITO CA 94965

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
MENDOCINO BREWING CO INC [ MENB ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
Chairman, CEO
3. Date of Earliest Transaction (Month/Day/Year)
08/14/2004
4. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
X Form filed by One Reporting Person
Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V Amount (A) or (D) Price
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 3) 2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 4. Transaction Code (Instr. 8) 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) 6. Date Exercisable and Expiration Date (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) 8. Price of Derivative Security (Instr. 5) 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Convertible Note $1.5 08/14/2004 J(1) 0 08/14/2004 (3) Common Stock(2) 0 $0 1,515,371 I See Footnote
Explanation of Responses:
1. Pursuant to a Fourth Amendment to Extension of Term of Notes Under Master Line of Credit Agreement dated August 14, 2004 (the "Amendment") between the Issuer and United Breweries of America, Inc. ("UBA"), the terms of all of the promissory notes (the "Notes") issued pursuant to the Master Loan Agreement, as amended, between the Issuer and UBA have been extended until August 31, 2005. Unless the Notes are repaid prior to August 31, 2005, they will continue to earn interest until that date. This increase in the period of time during which the Notes will earn interest may cause an increase in the number of shares of the Issuer's Common Stock which may be purchased upon UBA's conversion of the Notes. As of August 14, 2004, the outstanding principal on the Notes was $1,515,371, which corresponds to the right to purchase 1,010,247 shares of Common Stock and the outstanding interest was $458,695, which corresponds to the right to purcahse 305,797 shares of Common Stock.
2. The Reporting Person may be deemed to be the majority beneficial owner of UBA, the record holder of the Issuer's Notes. UBA is owned by a foreign corporation, the shares of which are conrolled by fiduciaries who may exercise discretion in favor of the Reporting Person amongst others.
3. Not applicable.
/s/ Dr. Vijay Mallya 08/14/2004
** Signature of Reporting Person Date
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v).
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a).
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