UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549INITIAL 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(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | SEC 1473 (7-02) | ||
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. |
1. Title of Derivative Security (Instr. 4) |
2. Date Exercisable and Expiration Date (Month/Day/Year) |
3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) |
4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) |
6. Nature of Indirect Beneficial Ownership (Instr. 5) |
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Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Convertible Preferred Stock | Â (2) | Â (3) | Common Stock | 45,000 | $ (4) | D | Â |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
GOLDMAN KEVIN 275 WAGARAW ROAD HAWTHORNE, NJ 07506 |
 |  X |  |  |
Kevin Goldman | 12/20/2012 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 5(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). |
(1) | The Form 3 filed by Kevin Goldman on December 14, 2012 is amended to include the following additional information: Kevin Goldman is the son of Michael Goldman who is Chairman of CCOM Group, Inc. (the "Company"). In addition to the shares of convertible preferred stock that Kevin Goldman owns beneficially, through his ownership of 25% of Goldman Associates of New York, Inc. ("Goldman Associates") he also owns the pecuniary interest in 998,564 shares (10.9% of the outstanding shares of common stock) of a total of 3,994,255 shares of common stock that are owned by Goldman Associates (the "Goldman Associates Shares"). Michael Goldman is the chief executive officer and the majority shareholder of Goldman Associates and is the beneficial owner of the Goldman Associates Shares. Kevin Goldman disclaims beneficial ownership of the Goldman Associates Shares. |
(2) | Immediately |
(3) | There is no expiration date for Convertible Preferred Stock. |
(4) | Conversion to Common Stock on a 1 to 1 basis |