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3235-0145 | |
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602910101 (CUSIP Number) |
* |
The remainder of this cover page shall be filled out for a reporting persons initial filing on this form with respect to the subject class of securities,
and for any subsequent amendment containing information which would alter disclosures provided in a prior cover page. |
1. |
Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). N.A. Degerstrom, Inc. 91-0698638 | |
2. |
Check the Appropriate Box if a Member of a Group (See Instructions) (a) ¨ (b) x | |
3. |
SEC Use Only | |
4. |
Source of Funds (See Instructions) WC | |
5. |
Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e) ¨ | |
6. |
Citizenship or Place of Organization Washington | |
7. |
Sole Voting Power 7,450,000 | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
8. |
Shared Voting Power | ||
EACH REPORTING PERSON WITH |
9. |
Sole Dispositive Power 7,450,000 | ||
10. |
Shared Dispositive Power | |||
11. |
Aggregate Amount Beneficially Owned by Each Reporting Person 7,450,000 | |
12. |
Check if the Aggregate Amount in Row (11) Excludes Certain Shares (See Instructions) x | |
13. |
Percent of Class Represented by Amount in Row (11) 20% | |
14. |
Type of Reporting Person (See Instructions) CO | |
1. |
Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). Neal A. Degerstrom | |
2. |
Check the Appropriate Box if a Member of a Group (See Instructions) (a) ¨ (b) x | |
3. |
SEC Use Only | |
4. |
Source of Funds (See Instructions) AF | |
5. |
Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e) ¨ | |
6. |
Citizenship or Place of Organization USA | |
7. |
Sole Voting Power | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
8. |
Shared Voting Power 7,450,000 | ||
EACH REPORTING PERSON WITH |
9. |
Sole Dispositive Power | ||
10. |
Shared Dispositive Power 7,450,000 | |||
11. |
Aggregate Amount Beneficially Owned by Each Reporting Person 7,450,000 | |
12. |
Check if the Aggregate Amount in Row (11) Excludes Certain Shares (See Instructions) x | |
13. |
Percent of Class Represented by Amount in Row (11) 20% | |
14. |
Type of Reporting Person (See Instructions) IN | |
1. |
Names of Reporting Persons. I.R.S. Identification Nos. of above persons (entities only). Joan Degerstrom | |
2. |
Check the Appropriate Box if a Member of a Group (See Instructions) (a) ¨ (b) x | |
3. |
SEC Use Only | |
4. |
Source of Funds (See Instructions) AF | |
5. |
Check if Disclosure of Legal Proceedings Is Required Pursuant to Items 2(d) or 2(e) ¨ | |
6. |
Citizenship or Place of Organization USA | |
7. |
Sole Voting Power | |||
NUMBER OF SHARES BENEFICIALLY OWNED BY |
8. |
Shared Voting Power 7,450,000 | ||
EACH REPORTING PERSON WITH |
9. |
Sole Dispositive Power | ||
10. |
Shared Dispositive Power 7,450,000 | |||
11. |
Aggregate Amount Beneficially Owned by Each Reporting Person 7,450,000 | |
12. |
Check if the Aggregate Amount in Row (11) Excludes Certain Shares (See Instructions) x | |
13. |
Percent of Class Represented by Amount in Row (11) 20% | |
14. |
Type of Reporting Person (See Instructions) IN | |
Name |
Principal Occupation |
Citizenship |
Position with Degerstrom | |||
Neal A. Degerstrom |
President of Degerstrom |
USA |
President; Director | |||
Joan Degerstrom |
Vice President of Degerstrom |
USA |
Vice-President; Director | |||
Gary Craig |
Vice PresidentOperations of Degerstrom |
USA |
Vice PresidentOperations; Director | |||
Michael Cannon |
Secretary/Treasurer of Degerstrom |
USA |
Secretary/Treasurer | |||
Richard Stager |
Vice PresidentEngineering of Degerstrom |
USA |
Vice PresidentEngineering | |||
James Fish |
Vice PresidentGeneral Counsel of Degerstrom |
USA |
Vice PresidentGeneral Counsel | |||
Michael Coleman |
Vice PresidentEnvironmental Services of Degerstrom |
USA |
Vice PresidentEnvironmental Services | |||
Paul Hatfield |
Vice PresidentMining of Degerstrom |
USA |
Vice PresidentMining |
Party identified in Item 2 |
Shares beneficially owned (#) |
Percentage of class |
Shares over which there is sole power to vote (#) |
Shares over which there is shared power to vote (#) |
Shares over which there is sole power to direct disposition (#) |
Shares over which there is shared power to direct disposition (#) | ||||||||
N.A. Degerstrom, Inc. |
7,450,000 |
(3) |
20 |
(4) |
7,450,000 |
0 |
7,450,000 |
0 | ||||||
Neal A. Degerstrom |
7,450,000 |
(1)(2)(3) |
20 |
(4) |
0 |
7,450,000 |
0 |
7,450,000 | ||||||
Joan Degerstrom |
7,450,000 |
(1)(2)(3) |
20 |
(4) |
0 |
7,450,000 |
0 |
7,450,000 |
(1) |
Does not include 1,213,409 shares issuable pursuant to the Performance Right. |
(2) |
Shares are beneficially owned by virtue of control of N.A. Degerstrom, Inc., which controlling shares are held jointly by Neal A. Degerstrom and Joan Degerstrom
as husband and wife. |
(3) |
Includes 1,175,000 shares issuable upon exercise of Special Warrants and 1,175,000 shares issuable upon exercise of common stock purchase warrants (which were
issued upon exercise of the Special Warrants). |
(4) |
Assumes exercise of underlying common stock purchase warrants. |
Item |
6. Contracts, Arrangements, Understandings or Relationships with Respect to Securities of the Issuer
|
7.1 |
Subscription Agreement between Minera Andes and Degerstrom dated November 30, 2000. (Incorporated by reference from
Amendment No. 1 to Schedule 13D filed for the event on November 30, 2000.) | |
7.2 |
Asset and Share Acquisition Agreement between Minera Andes S.A., NAD S.A., Minera Andes, Degerstrom, Brian Gavin,
Jorge Vargas and Enrique Rufino Marzari Elizalde, dated March 8, 1995, as amended on April 19, 1996. (Incorporated by reference to Exhibit 2.1 of Minera Andes Registration Statement on Form 10-SB (SEC File No. 000-22731)). |
N.A. DEGERSTROM, INC. | ||
By: |
/s/ NEAL A.
DEGERSTROM | |
Neal A. Degerstrom, President | ||
/s/ NEAL A.
DEGERSTROM Neal A. Degerstrom |
||
/s/ JOAN
DEGERSTROM | ||
Joan Degerstrom |
Sequential Exhibit No. |
Description | |
7.1 |
Subscription Agreement between Minera Andes and Degerstrom dated November 30, 2000. (Incorporated by reference from
Amendment No. 1 to Schedule 13D filed for the event on November 30, 2000.) | |
7.2 |
Asset and Share Acquisition Agreement between Minera Andes S.A., NAD S.A., Minera Andes, Degerstrom, Brian Gavin,
Jorge Vargas and Enrique Rufino Marzari Elizalde, dated March 8, 1995, as amended on April 19, 1996. (Incorporated by reference to Exhibit 2.1 of Minera Andes Registration Statement on Form 10-SB (SEC File No. 000-22731)). |