- Statement of Changes in Beneficial Ownership (4)
November 17 2009 - 3:54PM
Edgar (US Regulatory)
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FORM 4
[ ]
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue.
See
Instruction 1(b).
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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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
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1. Name and Address of Reporting Person
*
FAIRCHILD SAMUEL W
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2. Issuer Name
and
Ticker or Trading Symbol
ENERGY COMPOSITES Corp
[
ENCC
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
Chief Executive Officer
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(Last)
(First)
(Middle)
4400 COMMERCE DRIVE
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3. Date of Earliest Transaction
(MM/DD/YYYY)
11/13/2009
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(Street)
WISCONSIN DRIVE, WI 54494
(City)
(State)
(Zip)
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4. If Amendment, Date Original Filed
(MM/DD/YYYY)
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6. Individual or Joint/Group Filing
(Check Applicable Line)
_
X
_ Form filed by One Reporting Person
___ Form filed by More than One Reporting Person
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
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1.Title of Security
(Instr. 3)
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2. Trans. Date
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2A. Deemed Execution Date, if any
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3. Trans. Code
(Instr. 8)
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4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
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6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4)
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7. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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Amount
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(A) or (D)
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Price
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Common Stock
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11/13/2009
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P
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100
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A
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$4.672
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256000
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D
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Common Stock
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11/13/2009
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J
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7996
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A
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(1)
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263996
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D
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Common Stock
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11/16/2009
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P
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200
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A
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$4.446
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264196
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D
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Common Stock
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11/13/2009
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J
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744596
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D
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(1)
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0
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I
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By ECC Investment Partners, LLC
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Common Stock
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11/13/2009
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J
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40000
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A
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(1)
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40000
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I
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By Spouse and minor children
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Table II - Derivative Securities Beneficially Owned (
e.g.
, puts, calls, warrants, options, convertible securities)
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1. Title of Derivate Security
(Instr. 3)
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2. Conversion or Exercise Price of Derivative Security
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3. Trans. Date
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3A. Deemed Execution Date, if any
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4. Trans. Code
(Instr. 8)
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5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
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6. Date Exercisable and Expiration Date
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7. Title and Amount of Securities Underlying Derivative Security
(Instr. 3 and 4)
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8. Price of Derivative Security
(Instr. 5)
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9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4)
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10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4)
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11. Nature of Indirect Beneficial Ownership (Instr. 4)
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Code
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V
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(A)
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(D)
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Date Exercisable
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Expiration Date
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Title
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Amount or Number of Shares
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Warrants
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$5.00
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11/13/2009
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J
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560000
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8/6/2008
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8/6/2011
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Common Stock
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560000
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(1)
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0
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I
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By ECC Investment Partners, LLC
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Warrants
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$5.00
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11/13/2009
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J
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160000
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11/17/2008
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11/17/2011
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Common Stock
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160000
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(1)
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0
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I
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By ECC Investment Partners, LLC
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Warrants
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$5
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11/13/2009
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J
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10000
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12/15/2008
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12/15/2011
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Common Stock
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10000
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(1)
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0
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I
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By ECC Investment Partners, LLC
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Warrants
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$5.00
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11/13/2009
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J
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25631
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8/6/2008
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8/6/2011
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Common Stock
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25631
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(1)
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25631
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I
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By Spouse and minor children
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Warrants
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$5.00
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11/13/2009
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J
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7318
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11/17/2008
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11/17/2011
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Common Stock
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7318
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(1)
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7318
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I
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By Spouse and minor children
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Warrants
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$5.00
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11/13/2009
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J
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451
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12/15/2008
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12/15/2011
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Common Stock
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451
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(1)
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451
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I
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By Spouse and minor children
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Explanation of Responses:
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(
1)
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ECC Investment Partners, LLC dissolved and distributed its assets, which were shares and warrants of Energy Composites Corporation, to its members. Mr. Fairchild, a manager of ECC Investment Partners, LLC, had been attributed beneficial ownership of the shares and warrants. With this distribution, he is deemed to beneficially own shares and warrants owned of record by him and his immediate family members who reside in his household.
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Reporting Owners
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Reporting Owner Name / Address
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Relationships
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Director
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10% Owner
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Officer
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Other
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FAIRCHILD SAMUEL W
4400 COMMERCE DRIVE
WISCONSIN DRIVE, WI 54494
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X
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Chief Executive Officer
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Signatures
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Samuel W. Fairchild
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11/17/2009
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**
Signature of Reporting Person
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Date
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly.
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*
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If the form is filed by more than one reporting person,
see
Instruction 4(b)(v).
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**
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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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Note:
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File three copies of this Form, one of which must be manually signed. If space is insufficient,
see
Instruction 6 for procedure.
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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 control number.
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