Report of Proposed Sale of Securities (144)
04 Février 2013 - 12:02PM
Edgar (US Regulatory)
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UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 144
NOTICE OF PROPOSED SALE OF SECURITIES
PURSUANT TO RULE 144 UNDER THE SECURITIES ACT OF 1933
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OMB APPROVAL
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OMB Number: 3235-0101
Expires: February 28, 2014
Estimated average burden hours per response .. . . . 2.00
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SEC USE ONLY
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DOCUMENT SEQUENCE NO.
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CUSIP NUMBER
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ATTENTION:
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Transmit for filing 3 copies of this form concurrently with either placing an order with a broker to execute sale or executing a sale directly with a market maker.
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1
(a)
NAME OF ISSUER
(Please type or print)
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(b)
IRS IDENT. NO.
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(c)
S.E.C. FILE NO.
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WORK LOCATION
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APPIPHANY TECHNOLOGIES HOLDINGS CORP.
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300678378
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54524
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1
(d)
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ADDRESS OF ISSUER
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STREET
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CITY
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STATE
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ZIP CODE
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(e)
TELEPHONE NO.
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P.O. BOX ORCHARD PARK, KELOWNA
BC V1Y9N8
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AREA
CODE
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NUMBER
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205
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8645377
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2
(a)
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NAME OF PERSON FOR WHOSE ACCOUNT THE SECURITIES ARE TO BE SOLD
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(b)
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IRS IDENT. NO.
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(c)
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RELATIONSHIP TO ISSUER
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(d)
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ADDRESS STREET
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CITY
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STATE
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ZIP CODE
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JESSE KELLER
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PRES/CEO
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403-1630 PANDOSY, KELOWNA BC V1Y1P7
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INSTRUCTION: The person filing this notice should contact the issuer to obtain the I.R.S. Identification Number and the S.E.C. File Number.
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3
(a)
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Title of the Class of Securities To Be Sold
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(b)
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Name and Address of Each Broker Through Whom the Securities are to be Offered or Each Market Maker who is Acquiring the Securities
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SEC USE ONLY
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(c)
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Number of Shares
or Other Units
To Be Sold
(See instr. 3(c))
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(d)
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Aggregate
Market
Value
(See instr. 3(d))
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(e)
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Number of Shares
or Other Units
Outstanding
(See instr. 3(e))
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(f)
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Approximate Date of Sale
(See instr. 3(f))
(MO. DAY YR.)
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(g)
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Name of Each Securities Exchange
(See instr. 3(g))
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Broker-Dealer
File Number
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COMMON
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TITAN INTERNATIONAL SECURITIES, INC.
SUITE 403, THE MATALON, CONEY DRIVE
P.O. BOX 2135
BELIZE CITY, BELIZE
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73000
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$21000
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9537038
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02/01/13
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OTCBB
OTCQB
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1.
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(a)
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Name of issuer
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3.
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(a)
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Title of the class of securities to be sold
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(b)
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Issuers I.R.S. Identification Number
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(b)
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Name and address of each broker through whom the securities are intended to be sold
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(c)
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Issuers S.E.C. file number, if any
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(c)
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Number of shares or other units to be sold (if debt securities, give the aggregate face amount)
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(d)
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Issuers address, including zip code
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(d)
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Aggregate market value of the securities to be sold as of a specified date within 10 days prior to the filing of this notice
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(e)
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Issuers telephone number, including area code
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(e)
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Number of shares or other units of the class outstanding, or if debt securities the face amount thereof outstanding, as shown by the most recent report or statement published by the issuer
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(f)
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Approximate date on which the securities are to be sold
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2.
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(a)
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Name of person for whose account the securities are to be sold
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(g)
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Name of each securities exchange, if any, on which the securities are intended to be sold
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(b)
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Such persons I.R.S. identification number, if such person is an entity
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(c)
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Such persons relationship to the issuer (e.g., officer, director, 10% stockholder, or member of immediate family of any of the foregoing)
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(d)
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Such persons address, including zip code
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Potential persons who are to 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.
SEC 1147 (08-07)
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Form 144 Worksheet provided by
Securex EDGAR Filing Service Bureau877-SEC-FILE (Option 1)
www.secfile.net
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file@secfile.net
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TABLE I SECURITIES TO BE SOLD
Furnish the following information with respect to the acquisition of the securities to be sold and with respect to the payment of all or any part of the purchase price or other consideration therefor:
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Title of
the Class
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Date you Acquired
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Nature of Acquisition Transaction
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Name of Person from Whom Acquired
(If gift, also give date donor acquired)
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Amount of Securities Acquired
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Date of Payment
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Nature of Payment
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COMMON
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05/01/10
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SHARE EXCHANGE
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ISSUER
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500000
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05/01/10
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SHARE EXCHANGE
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INSTRUCTIONS:
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If the securities were purchased and full payment therefor was not made in cash at the time of purchase, explain in the table or in a note thereto the nature of the consideration given. If the consideration consisted of any note or other obligation, or if payment was made in installments describe the arrangement and state when the note or other obligation was discharged in full or the last installment paid.
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TABLE II SECURITIES SOLD DURING THE PAST 3 MONTHS
Furnish the following information as to all securities of the issuer sold during the past 3 months by the person for whose account the securities are to be sold.
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Name and Address of Seller
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Title of Securities Sold
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Date of Sale
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Amount of Securities Sold
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Gross Proceeds
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N/A
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N/A
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N/A
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N/A
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N/A
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INSTRUCTIONS:
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ATTENTION:
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See the definition of
person
in paragraph (a) of Rule 144. Information is to be given not only as to the person for whose account the securities are to be sold but also as to all other persons included in that definition. In addition, information shall be given as to sales by all persons whose sales are required by paragraph (e) of Rule 144 to be aggregated with sales for the account of the person filing this notice.
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The person for whose account the securities to which this notice relates are to be sold hereby represents by signing this notice that he does not know any material adverse information in regard to the current and prospective operations of the Issuer of the securities to be sold which has not been publicly disclosed.
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2/1/2013
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/s/ Jesse Keller
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DATE OF NOTICE
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(SIGNATURE)
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The notice shall be signed by the person for whose account the securities are to be sold. At least one copy of the notice shall be manually signed.
Any copies not manually signed shall bear typed or printed signatures.
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ATTENTION: Intentional misstatements or omission of facts constitute Federal Criminal Violations (See 18 U.S.C. 1001)
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Form 144 Worksheet provided by
Securex EDGAR Filing Service Bureau877-SEC-FILE (Option 1)
www.secfile.net
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file@secfile.net
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