SEC Form 5
FORM 5 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 ANNUAL 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 |
| |||||||||||||||
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). | |||||||||||||||||
| Form 3 Holdings Reported. | ||||||||||||||||
Form 4 Transactions Reported. |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol AMERICATOWNE Inc. [ NONE ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| ||||||||||||||||||||||||
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year) 12/31/2016 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
|
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 at end of Issuer's Fiscal Year (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||||||
Amount | (A) or (D) | Price | |||||||||||||
Common Stock(1) | 3 | 13,756,216 | D | ||||||||||||
Common Stock(2) | 3 | 7,948,939 | D | ||||||||||||
Common Stock(3) | 3 | 23,466,426 | I | Yilaime Corp., Alton & Mei Lin Perkins Family Trust, AXPT 3 | |||||||||||
Common Stock(4) | 3 | 0 | D | ||||||||||||
Common Stock(5) | 3 | 0 | D |
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) | |||
(A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
| ||||||||||||
1. Name and Address of Reporting Person*
(Street)
|
Explanation of Responses: |
1. Held by Yilaime Corp. |
2. Held by Alton & Xiang Mei Lin Perkins Family Trust. |
3. Held by Alton Perkins. |
4. Perkins Hsu Export Corp. ("Perkins Hsu") makes this report because its principal - Alton Perkins, is the beneficial owner of the majority and controlling interest in the Issuer. Perkins Hsu owns 16,536 shares of common stock in the Issuer. |
5. The AXP Nevada Asset Protection Trust 3 ("AXP Nevada") makes this report because its principal - Alton Perkins, is the beneficial owner of the majority and controlling interest in the Issuer. AXP Nevada owns 120,000 shares of common stock in the Issuer. |
Remarks: |
Yilaime Corp NC CIK#: 0001595899 owns 1,000 shares whose princiapl is also Alton Perkins, the beneficial owner of the majority and controlling interest of the Issuer. Yilaime Corp NC is not a 10% owner. |
Leisanne Smeadala, Limited Power of Attorney for Alton Perkins on behalf of Yilaime Corp. | 02/14/2017 | |
Leisanne Smeadala, Limited Power of Attorney for Alton Perkins on behalf of Alton & Xiang Mei Lin Perkins Family Trust | 02/14/2017 | |
Leisanne Smeadala, Limited Power of Attorney for Alton Perkins | 02/14/2017 | |
Leisanne Smeadala, Limited Power of Attorney for Alton Perkins on behalf of Perkins Hsu Export Corp. | 02/14/2017 | |
Leisanne Smeadala, Limited Power of Attorney for Alton Perkins on behalf of AXP Nevada Asset Protection Trust 3 | 02/14/2017 | |
** 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). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |