Statement of Changes in Beneficial Ownership (4)
February 20 2013 - 2:07PM
Edgar (US Regulatory)
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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OMB APPROVAL
OMB Number:
3235-0287
Estimated average burden
hours per response...
0.5
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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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1. Name and Address of Reporting Person
*
Carlson Daniel F
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2. Issuer Name
and
Ticker or Trading Symbol
COLOMBIA ENERGY RESOURCES, INC.
[
CERX
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
_____ 10% Owner
_____ Officer (give title below)
_____ Other (specify below)
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(Last)
(First)
(Middle)
38 HUNTER CREEK ROAD
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3. Date of Earliest Transaction
(MM/DD/YYYY)
2/20/2013
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(Street)
FAIRFAX, CA 94930
(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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2/20/2013
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J
(1)
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36836
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D
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$0
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410234
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D
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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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Options
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$2.5
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(2)
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2/28/2015
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Common Stock
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50000
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50000
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D
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Options
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$5
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(2)
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2/28/2015
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Common Stock
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50000
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100000
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D
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Restricted Stock Units
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$0
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(3)
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(3)
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Common Stock
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35700
(3)
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135700
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D
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Restricted Stock Units
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$0
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(4)
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(4)
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Common Stock
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83333
(4)
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219033
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D
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Explanation of Responses:
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(
1)
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Volunitarily returned shares to the Issuer.
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(
2)
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Vesting: 3 years, 25% immediate and 25% on each anniversary for 3 years.
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(
3)
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The restricted stock units ("RSUs") vested on May 8, 2012 and will expire at end of the director's term. If the director resigns for cause or is removed for cause before the end of his term, the RSUs would lapse. However, if the director resigns for health or other appropriate reasons, his RSUs would vest immediately. The director is not permitted to sell the vested shares until he is no longer a director.
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(
4)
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The restricted stock units ("RSUs") will vest on the date of the 2013 annual meeting of stockholders and will expire at end of the director's term. If the director resigns for cause or is removed for cause before the end of his term, the RSUs would lapse. However, if the director resigns for health or other appropriate reasons, his RSUs would vest immediately. The director is not permitted to sell the vested shares until he is no longer a director.
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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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Carlson Daniel F
38 HUNTER CREEK ROAD
FAIRFAX, CA 94930
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X
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Signatures
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/s/ Daniel F. Carlson
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2/20/2013
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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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