Attached files
As filed with the Securities and Exchange Commission on February 18, 2014
Registration No.333-192228
==============================================================================
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
FORM S-1/A
Amendment No. 2
REGISTRATION STATEMENT UNDER THE SECURITIES ACT OF 1933
THREE FORKS, INC.
-----------------------------------------------------------
(Exact name of registrant as specified in its charter)
COLORADO 1381 45-4915308
------------------------------ ---------------------------- -------------------
(State or jurisdiction of (Primary Standard Industrial (I.R.S. Employer
incorporation or organization) Classification Code Number) Identification No.)
555 ELDORADO BLVD., SUITE 100, BROOMFIELD, COLORADO 80021/ PHONE (303)404-2160
------------------------------------------------------------------------------
(Address and telephone number of principal executive offices)
W. EDWARD NICHOLS, CHIEF EXECUTIVE OFFICER AND DIRECTOR
555 ELDORADO BLVD., SUITE 100, BROOMFIELD, COLORADO 80021/ PHONE (303)404-2160
------------------------------------------------------------------------------
(Name, address and telephone number of agent for service)
COPIES OF ALL COMMUNICATIONS TO:
Michael A. Littman, Attorney at Law
7609 Ralston Road, Arvada, CO, 80002 phone 303-422-8127 / fax 303-431-1567
Approximate date of commencement of proposed sale to the public: As soon as
possible after this Registration Statement becomes effective.
If any of the securities being registered on this Form are to be offered on a
delayed or continuous basis pursuant to Rule 415 under the Securities Act of
1933, check the following box. [X]
If this Form is filed to register additional securities for an offering pursuant
to Rule 462(b) under the Securities Act, please check the following box and list
the Securities Act registration statement number of the earlier effective
registration statement for the same offering. [ ]
If this Form is a post-effective amendment filed pursuant to Rule 462(c) under
the Securities Act, check the following box and list the Securities Act
registration statement number of the earlier effective registration statement
for the same offering. [ ]
If this Form is a post effective amendment filed pursuant to Rule 462(d) under
the Securities Act, check the following box and list the Securities Act
registration statement number of the earlier effective registration statement
for the same offering. [ ]
Indicate by check mark whether the registrant is a large accelerated filer, an
accelerated filer, a non-accelerated filer, or a smaller reporting company. See
the definitions of "large accelerated filer," "accelerated filer" and "smaller
reporting company" in Rule 12b-2 of the Exchange Act.
--------------------------- ----------- -------------------------- ------------
Large accelerated filer [___] Accelerated filer [___]
--------------------------- ----------- -------------------------- ------------
Non-accelerated filer [___] Smaller reporting company [_X_]
(Do not check if a smaller
reporting company)
--------------------------- ----------- -------------------------- ------------
CALCULATION OF REGISTRATION FEE
TITLE OF EACH CLASS OF AMOUNT TO BE PROPOSED MAXIMUM PROPOSED MAXIMUM AMOUNT OF
SECURITIES TO BE REGISTERED REGISTERED OFFERING PRICE PER SHARE AGGREGATE OFFERING REGISTRATION
PRICE(1) FEE
---------------------------- ------------------ ------------------------- --------------------------- ----------------
Common Stock by Selling 3,637,028 $1.50 $5,455,542 $702.67 (2)
Shareholders
(1) Estimated solely for the purpose of computing the registration fee pursuant
to Rule 457(o) under the Securities Act.
(2) The Registration Fee of $702.67 was paid in November 2013.
The registrant hereby amends this registration statement on such date or dates
as may be necessary to delay its effective date until the registrant shall file
a further amendment which specifically states that this registration statement
shall thereafter become effective in accordance with Section 8(a) of the
Securities Act of 1933 or until the registration statement shall become
effective on such date as the Commission, acting pursuant to said Section 8(a),
may determine.
EXPLANATORY NOTE
Three Forks, Inc. (the "Company") is filing this Amendment to its Registration
Statement on S-1/A filed with the Securities and Exchange Commission on January
31, 2014 for the sole purpose of updating Item 12 - Incorporation of Certain
Information by Reference and Item 16 - Financial Statements and Exhibits,
specifically to include changes to Exhibit 10.18.
This Amendment does not reflect events occurring after the original filing on
January 31, 2014, except as noted above. Except for the foregoing amended
information, this S-1/A continues to speak as of the date of original filing on
January 31, 2014 and the Company has not otherwise updated disclosures contained
therein or herein to reflect events that occurred at a later date.
ii
TABLE OF CONTENTS
========================== =================================================== =============
PART I - INFORMATION
REQUIRED IN PROSPECTUS Page No.
-------------------------- --------------------------------------------------- -------------
ITEM 12. Incorporation of Certain Information by Reference 2
-------------------------- --------------------------------------------------- -------------
PART II - INFORMATION NOT
REQUIRED IN PROSPECTUS
-------------------------- --------------------------------------------------- -------------
ITEM 13. Other Expenses of Issuance and Distribution 4
-------------------------- --------------------------------------------------- -------------
ITEM 14. Indemnification of Directors and Officers 4
-------------------------- --------------------------------------------------- -------------
ITEM 15. Recent Sales of Unregistered Securities 5
-------------------------- --------------------------------------------------- -------------
ITEM 16. Exhibits and Financial Statement Schedules 13
-------------------------- --------------------------------------------------- -------------
ITEM 17. Undertakings 15
-------------------------- --------------------------------------------------- -------------
Signatures 16
-------------------------- --------------------------------------------------- -------------
-1-
ITEM 12. INCORPORATION OF CERTAIN INFORMATION BY REFERENCE
----------------------------------------------------------
-------------- ------------------------------------------------------------------------ ---------------------------
EXHIBIT NO. DESCRIPTION
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).1 Articles of Incorporation of Three Forks, Inc. - 3/28/12 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).2 Articles of Organization of Three Forks No. 1, LLC - 11/8/2012 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).3 Articles of Incorporation of Three Forks Operating Company, Inc. - (1)
1/2/13
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).4 Articles of Amendment - Name Change to TFI Operating Company, Inc. - (1)
2/8/13
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).5 Articles of Organization of Three Forks LLC No. 2 - 12/4/2013 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
3(ii).1 Bylaws of Three Forks, Inc. (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(ii).2 Bylaws of TFI Operating Company (fka Three Forks Operating Company, (1)
Inc.)
-------------- ------------------------------------------------------------------------ ---------------------------
5.1 Opinion re: Legality (2)
-------------- ------------------------------------------------------------------------ ---------------------------
10.1 Employment Agreement, Donald Walford (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.2 Amendment to Employment Agreement, Donald Walford (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.3 Consulting Agreement with W. Edward Nichols (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.4 Amendment to Consulting Agreement with W. Edward Nichols (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.5 Employment Agreement, Charles Pollard (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.6 Operating Agreement of Three Forks No. 1, LLC (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.7 Amendment to Operating Agreement of Three Forks No. 1, LLC (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.8 Certificate of Designation of Class A Convertible Preferred Stock (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.9 Stock Option Plan (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.10 Farmout Agreement (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.11 Purchase & Sale Agreement, Three Forks, Inc. & TFI No. 1, LLC 12/31/12 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.12 Purchase, Sale & Participation Agreement, Five Jab, Inc. & Three (2)
Forks, Inc. 2/27/13
-------------- ------------------------------------------------------------------------ ---------------------------
10.13 Blue Quail, Ltd. Participation Agreement 4/8/13 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.14 1st Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc. 4/30/13
-------------- ------------------------------------------------------------------------ ---------------------------
10.15 2nd Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
-2-
10.16 3rd Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
10.17 4th Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
10.18 Form of Convertible Promissory Note & Mortgage, Security and Pledge (4)
Agreement
-------------- ------------------------------------------------------------------------ ---------------------------
10.19 Operating Agreement of Three Forks LLC No. 2 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
23.1 Consent of Attorney (2)
-------------- ------------------------------------------------------------------------ ---------------------------
23.2 Consent of Independent Registered Public Accounting Firm Filed Herewith
-------------- ------------------------------------------------------------------------ ---------------------------
99.1 Archer County, Texas picture, page 26 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
99.2 Pink Project, Pottawatamie County, Oklahoma picture, page 27 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
101.INS XBRL Instance Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.SCH XBRL Taxonomy Extension Schema Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.DEF XBRL Taxonomy Extension Definition Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.LAB XBRL Taxonomy Extension Label Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.PRE XBRL Taxonomy Extension Presentation Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
(1) Incorporated by reference from the exhibits included in the Company's Form
10-12g/A filed with the Securities and Exchange Commission (www.sec.gov),
filed October 29, 2013.
(2) Incorporated by reference from the exhibits included in the Company's Form
10-12G/A No. 2 filed with the Securities and Exchange Commission
(www.sec.gov), filed January 31, 2014.
(3) Pursuant to Rule 406T of Regulation S-T, this interactive data file is
deemed not filed or part of a registration statement or prospectus for
purposes of Sections 11 or 12 of the Securities Act of 1933, is deemed not
filed for purposes of Section 18 of the Securities Exchange Act of 1934,
and otherwise is not subject to liability under these sections.
(4) Incorporated by reference from the exhibits included in the Company's Form
10-12G/A No. 3 filed with the Securities and Exchange Commission
(www.sec.gov), filed February 18, 2014.
-3-
[OUTSIDE BACK COVER PAGE OF PROSPECTUS]
DEALER PROSPECTUS DELIVERY REQUIREMENTS
PART II. INFORMATION NOT REQUIRED IN PROSPECTUS
-----------------------------------------------
ITEM 13. OTHER EXPENSES OF ISSUANCE AND DISTRIBUTION
----------------------------------------------------
We have expended, or will expend fees in relation to this registration statement
as detailed below:
================================================================= ==============
EXPENDITURE ITEM AMOUNT
----------------------------------------------------------------- --------------
Attorney Fees $13,000
----------------------------------------------------------------- --------------
Audit Fees $7,500
----------------------------------------------------------------- --------------
Transfer Agent Fees $2,000
----------------------------------------------------------------- --------------
SEC Registration and Blue Sky Registration fees (estimated) $1,000
----------------------------------------------------------------- --------------
Printing Costs and Miscellaneous Expenses (estimated) $1,500
------
----------------------------------------------------------------- --------------
TOTAL $25,000
================================================================= ==============
ITEM 14. INDEMNIFICATION OF DIRECTORS AND OFFICERS
--------------------------------------------------
Our officers and directors are indemnified as provided by the Colorado Revised
Statutes and the bylaws.
Under the Colorado Revised Statutes, director immunity from liability to a
company or its shareholders for monetary liabilities applies automatically
unless it is specifically limited by a company's Articles of Incorporation. Our
Articles of Incorporation do not specifically limit the directors' immunity.
Excepted from that immunity are: (a) a willful failure to deal fairly with us or
our shareholders in connection with a matter in which the director has a
material conflict of interest; (b) a violation of criminal law, unless the
director had reasonable cause to believe that his or her conduct was lawful or
no reasonable cause to believe that his or her conduct was unlawful; (c) a
transaction from which the director derived an improper personal profit; and (d)
willful misconduct.
Our bylaws provide that it will indemnify the directors to the fullest extent
not prohibited by Colorado law; provided, however, that we may modify the extent
of such indemnification by individual contracts with the directors and officers;
and, provided, further, that we shall not be required to indemnify any director
or officer in connection with any proceeding, or part thereof, initiated by such
person unless such indemnification: (a) is expressly required to be made by law,
(b) the proceeding was authorized by the board of directors, (c) is provided by
us, in sole discretion, pursuant to the powers vested under Colorado law or (d)
is required to be made pursuant to the bylaws.
Our bylaws provide that it will advance to any person who was or is a party or
is threatened to be made a party to any threatened, pending or completed action,
suit or proceeding, whether civil, criminal, administrative or investigative, by
reason of the fact that he is or was a director or officer of us, or is or was
serving at the request of us as a director or executive officer of another
company, partnership, joint venture, trust or other enterprise, prior to the
final disposition of the proceeding, promptly following request therefore, all
expenses incurred by any director or officer in connection with such proceeding
upon receipt of an undertaking by or on behalf of such person to repay said
amounts if it should be determined ultimately that such person is not entitled
to be indemnified under the bylaws or otherwise.
Our bylaws provide that no advance shall be made by us to an officer except by
reason of the fact that such officer is or was our director in which event this
paragraph shall not apply, in any action, suit or proceeding, whether civil,
criminal, administrative or investigative, if a determination is reasonably and
promptly made: (a) by the board of directors by a majority vote of a quorum
consisting of directors who were not parties to the proceeding, or (b) if such
quorum is not obtainable, or, even if obtainable, a quorum of disinterested
directors so directs, by independent legal counsel in a written opinion, that
the facts known to the decision-making party at the time such determination is
made demonstrate clearly and convincingly that such person acted in bad faith or
in a manner that such person did not believe to be in or not opposed to the best
interests of us.
-4-
ITEM 15. RECENT SALES OF UNREGISTERED SECURITIES
------------------------------------------------
We have sold securities since inception (March 28, 2012) without registering the
securities under the Securities Act of 1933 as shown in the following tables:
SHARES ISSUED FOR PRIVATE OFFERINGS
Since our inception in March 2012 through June 2012, we have shares of our
common stock at a price of $0.01 per share in exchange for cash to the
individuals and the amounts set forth below.
Number of Shares Consideration Name
--------------------------------------------------------------------------------
5,000 $ 50 Melvin & Judith Einsidler
20,000 $ 200 William C. Gascoigne
5,000 $ 50 Robert Bradley
5,500 $ 55 Donald Einsidler
100,000 $ 1,000 Jacobs Enterprises, Ltd
45,000 $ 450 Robert W. Simmons
10,000 $ 100 Robert Reynolds
11,000 $ 110 Richard Davis
30,000 $ 300 Dennis Kaboth
7,500 $ 75 Jeremy Isaacs
2,500 $ 25 David & Lois Einsidler
16,500 $ 165 Barry Isaacs
5,500 $ 55 Risa Einsidler
137,000 $ 1,370 Bruce Theuerkauf
19,500 $ 195 Ralph T. Meloro, Trustee of
the Lisa B. Meloro Irrevocable
Trust
40,000 $ 400 Dennis Noel
60,000 $ 600 Donald S. Heauser
30,000 $ 300 Eric Hample
150,000 $ 1,500 Dennis and MaryJo Gabriel
2,215 $ 22 Diane Leeds Einsidler
10,000 $ 100 Vladimir & Glida Scerbo
160,000 $ 1,600 Robert Scerbo
2,500 $ 25 Marc & Caryn Schneider
5,500 $ 55 Charles Ras
50,000 $ 500 James Ford
5,000 $ 50 John Phelps
21,000 $ 210 Sean Fleming
75,000 $ 750 Neilson Family Trust
150,000 $ 1,500 Michael McNally
2,500 $ 25 Joseph G. Hoenigmann
2,500 $ 25 Christopher Pesce
(REMAINDER OF PAGE LEFT BLANK INTENTIONALLY)
-5-
100,000 $ 1,000 Clarene O Hample Revocable
Trust, Brent Hample Trustee
7,500 $ 75 Leah & Greg Isaacs
67,000 $ 670 Joan M. Jacobson
17,000 $ 170 Christian Farr
20,000 $ 200 John Cooper
25,000 $ 250 Steve Remmert
25,000 $ 250 Gerald Smart Trust
6,500 $ 65 Michael Einsidler
16,667 $ 167 Alexander Biggs
16,667 $ 167 Thomas B. Biggs
7,000 $ 70 Leland Beckley
7,000 $ 70 Byron Beckley
7,000 $ 70 Trenton Toftoy
10,000 $ 100 James Iverson
100,000 $ 1,000 Robert & Cynthia Toftoy
25,000 $ 250 Joel Ripmaster
7,000 $ 70 Patricia Nauman
3,500 $ 35 Ralph Toftoy
5,000 $ 50 Monica Sherman
40,000 $ 400 Richard Rinella
5,000 $ 50 Bernard Rinella
17,000 $ 170 Breff Leasing
7,000 $ 70 Underhill Trucking -
25,000 $ 250 Gerald Smart Trust
200,000 $ 2,000 Henry Moxely
10,000 $ 100 Nicole Saunders
10,000 $ 100 Glenda Weiss
3,200 $ 32 Terry Jacobson
38,000 $ 380 Tom Ness
5,000 $ 50 John Bryan
25,000 $ 250 Robert & Donna Wittenauer
25,000 $ 250 Donna Wittenauer FBO LK Latimer
5,000 $ 50 Timothy Scott
10,000 $ 100 Patrick J. Donovan
25,000 $ 250 Mihcael Pryblo
100,000 $ 1,000 Adelaide Biggs
15,000 $ 150 George Biggs
15,000 $ 150 Marcia Biggs
15,000 $ 150 Adelaide Andrews
4,000 $ 40 Amanda Germany
40,000 $ 400 Paul Dragul
6,250 $ 63 Daniel and Lesli Underhill
2,500 $ 25 Stephen Cohen
3,400 $ 34 Ron Anderson
60,000 $ 600 Cracked Crab LLC
7,500 $ 75 Jeff Rosenberg
40,000 $ 400 Glenda Weiss
50,000 $ 500 Christopher Jacobs
2,500 $ 25 Joseph Willen
35,000 $ 350 Paul Dragul
40,000 $ 400 Steward Mosko
-6-
25,000 $ 250 Gary Walford
50,000 $ 500 Brian Remington
10,000 $ 100 Daniel Rainey
50,000 $ 500 E. Dean Davis
25,000 $ 250 Lawson Farmer
25,000 $ 250 Cain Griffin Group, LLc
6,000 $ 60 Charles W. Jones
4,000 $ 40 FNB Griffin custodian for
Individual IRA Charles W. Jones
2,500 $ 25 Edward Vitko
2,500 $ 25 Mike Vitko
11,667 $ 117 Robert & Cynthia Toftoy
500 $ 5 Marla Alstadt
250 $ 3 Gary Lee Young
From July 2012 through October 2012, we have shares of our common stock at a
price of $1.00 per share in exchange for cash to the individuals and the amounts
set forth below.
Number of Shares Consideration Name
--------------------------------------------------------------------------------
8,000 $ 8,000 Robert & Cynthia Toftoy
15,000 $ 15,000 Bruce Theuerkauf Jr.
50,000 $ 50,000 James Ford
1,000 $ 1,000 Brian Hassett
25,000 $ 25,000 Willie Love
15,000 $ 15,000 Robert Reynolds
100,000 $ 100,000 Edward Vitko
10,000 $ 10,000 Caryn & Marc Schneider
1,000 $ 1,000 Diane Leeds Einsidler
4,876 $ 4,876 Bruce Molloy FBO Mariana Molloy
6,000 $ 6,000 Bruce Molloy
10,000 $ 10,000 Larry & Gayla Johnson
12,000 $ 12,000 David Newman
25,000 $ 25,000 Michael Faletti, Jr.
5,000 $ 5,000 Robert Bradley
2,250 $ 2,250 Thomas G. Nixon
20,000 $ 20,000 Jonathan Sherman,
25,000 $ 25,000 William and Suzanne Knopf
100,000 $ 100,000 Alexander Withall Declaration fo
Trust- W. Knopf Trustee
10,000 $ 10,000 Bruce Molloy
50,000 $ 50,000 Christopher Jacobs
10,000 $ 10,000 Henry H. Moxley
6,000 $ 6,000 James H. Campbell
2,750 $ 2,750 Thomas and Linda Nixon
25,000 $ 25,000 Michael Pryblo
5,000 $ 5,000 James Iverson
37,000 $ 37,000 Paul Dragul
30,000 $ 30,000 David Kelley
6,000 $ 6,000 Cottonwood NB LLC
-7-
2,800 $ 2,800 Karen A. Baker
5,000 $ 5,000 Rodney J. Buhr
5,000 $ 5,000 Spyglass Capital Group LLC
2,000 $ 2,000 Samuel H. Rabin
14,000 $ 14,000 Ronald Cox
5,000 $ 5,000 Willie and Carol Love, Jr
20,000 $ 20,000 Steven A. Scalf
10,000 $ 10,000 Keil & Elizabeth Johnson
10,000 $ 10,000 Russel D. and Judith A. Noel
20,000 $ 20,000 Robert and Cynthia Toftoy
50,000 $ 50,000 Joan jacobson Trust
50,000 $ 50,000 James R. Stewart
5,000 $ 5,000 Irene A. Brown
5,000 $ 5,000 James Iverson
3,000 $ 3,000 Kenneth Knudson
100,000 $ 100,000 Dennis and MaryJo Gabriel
20,000 $ 20,000 Robert Scerbo
50,000 $ 50,000 Edward Vitko
30,000 $ 30,000 Falettiko Oil & Gas, LLc
25,000 $ 25,000 Mike Vitko
7,000 $ 7,000 Larry & Gayle Johnson
5,000 $ 5,000 Willie and Carol Love
6,000 $ 6,000 Vladimir Scerbo
25,000 $ 25,000 Robert Reynolds
10,000 $ 10,000 Bruce Theuerkauf Jr.
35,000 $ 35,000 Cain Griffin Group, Inc
30,000 $ 30,000 David. D. Duvick
25,000 $ 25,000 Caroline Justice
10,000 $ 10,000 Cottonwood NB LLC
10,000 $ 10,000 Steven A. Scalf
2,250 $ 2,250 Gary Lee Young
30,000 $ 30,000 David Kelley
10,000 $ 10,000 Sauney & Geraldine Pippin
20,000 $ 20,000 Steve Scalf
30,000 $ 30,000 Bernard Bols
16,667 $ 16,667 Breff Leasing
33,334 $ 33,334 Gary Underhill
50,000 $ 50,000 Bill Baber
13,000 $ 13,000 Debbie Hamen
2,000 $ 2,000 Bruce Theuerkauf Jr
81,000 $ 81,000 Dayspring Capital, LLC
12,500 $ 12,500 Tom Ness
7,500 $ 7,500 Robert Toftoy
2,500 $ 2,500 Edward Vitko
2,500 $ 2,500 Mike Vitko
-8-
From October 2012 through December 2012, we have shares of our common stock at a
price of $2.25 per share in exchange for cash to the individuals and the amounts
set forth below.
Number of Shares Consideration Name
--------------------------------------------------------------------------------
10,000 $ 22,500 Tamar and Bruce Mar
44,444 $ 99,999 James R. Stewart
40,000 $ 90,000 Rich Sharpenter
50 $ 113 Kathie Hayes
500 $ 1,125 Maria Terrazas
2,222 $ 5,000 Tim L. Briggs
1,000 $ 2,250 Edward W. Sharpenter
1,600 $ 3,600 Rodney Buhr
20,000 $ 45,000 Alexander Withall/ Knopf
20,000 $ 45,000 Eric Hample
9,955 $ 22,399 Rich Sharpenter
50 $ 113 Ned Sharpenter
50 $ 113 Becky sharpenter
50 $ 113 Nick Sharpenter
50 $ 113 Lindsey Sharpenter
50 $ 113 Lillian Sharpenter
50 $ 113 Marc Sharpenter
50 $ 113 Leanne Sharpenter
50 $ 113 Joanne Blincoe
50 $ 113 Jim Blincoe
50 $ 113 Todd Blincoe
50 $ 113 Marie Blincoe
50 $ 113 Sophie Blincoe
50 $ 113 Emma Blincoe
50 $ 113 Tom Blincoe
50 $ 113 Judy Blincoe
50 $ 113 Jay Blincoe
50 $ 113 Emily Blincoe
225 $ 506 Trevor J. Buhr
(REMAINDER OF PAGE LEFT BLANK INTENTIONALLY)
-9-
From January 2013 through September 2013, we have shares of our common stock at
a price of $3.00 per share in exchange for cash to the individuals and the
amounts set forth below.
Number of Shares Consideration Name
--------------------------------------------------------------------------------
20,000 $ 60,000 Dr William R. King
10,000 $ 30,000 Ronney Ledford Jr. LLc
10,000 $ 30,000 Francis Construction
10,000 $ 30,000 Lorie J.and Josephine Mangham, Jr.
10,000 $ 30,000 Tim Dender
1,034 $ 3,102 Rich Sharpenter
1,000 $ 3,000 Karen Anderson Baker
10,000 $ 30,000 William & Joyce Babb
6,665 $ 19,995 Ronnie Cain
7,000 $ 21,000 William Stewart
16 $ 48 Rich Sharpenter
16,667 $ 50,001 Seth Sleezer IV
8,333 $ 24,999 Ronney Ledford Jr.
66,667 $ 200,001 Lester Ranew
46,667 $ 140,001 FNB Griffin Custodian for
Individual IRA Timothy R. Dender
10,000 $ 30,000 FNB Griffin Custodian for
individual IRA Linda Jordan
2,000 $ 6,000 Kenneth and Shirley Thompson
13,334 $ 40,002 Barry L. Jacobson
26,667 $ 80,001 James and Teresa Stewart
8,334 $ 25,002 Jared and Christina Adam
3,333 $ 9,999 Ronnie Can
1,671 $ 5,013 Patricia K. Huber
10,000 $ 30,000 Amanda Remington
13,334 $ 40,002 Arthur C. Krepps III
10,000 $ 30,000 C. Roan Berry
1,500 $ 4,500 Creative Solutions Invesments, LLC
1,000 $ 3,000 Darrell L & Mary A Gulseth JTWROS
15,000 $ 45,000 Herbert T. Sears
20,000 $ 60,000 James and Teresa Stewart
500 $ 1,500 Kelly Anderson
500 $ 1,500 Kirk Anderson
500 $ 1,500 Kyle Anderson
3,500 $ 10,500 Mitchell Gulseth
20,000 $ 60,000 Raymond Dender
10,000 $ 30,000 Richard Coleman Clements
8,333 $ 24,999 Ronny Ledford Jr.
10,000 $ 30,000 SCI Investments, LLC
2,000 $ 6,000 Star Net Investments, LLC
100,000 $ 300,000 Robert E. Long
10,000 $ 30,000 Timothy Dender
(REMAINDER OF PAGE LEFT BLANK INTENTIONALLY)
-10-
500 $ 1,500 Kelly Anderson
500 $ 1,500 Kirk Anderson
500 $ 1,500 Kyle Anderson
500 $ 1,500 Marla Alstadt
10,000 $ 30,000 Amanda Remington
8,333 $ 24,999 Ronny Ledford Jr.
10,000 $ 30,000 Richard Coleman Clements
1,500 $ 4,500 Creative Solutions Invesments, LLC
2,000 $ 6,000 Star Set Investments, LLC
20,000 $ 60,000 Raymond Dender
20,000 $ 60,000 James and Teresa Stewart
3,333 $ 10,000 Ray & Betty Chally
10,000 $ 30,000 M&M Funding, LLC
12,000 $ 36,000 FNB Griffin Custodian for
William C. Weldon IRA
10,000 $ 30,000 FNB Griffin Custodian for
Wendy Williams IRA
10,000 $ 30,000 FNB Griffin Custodian for
Lewis G. Sanders IRA
10,000 $ 30,000 FNB Griffin Custodian for
William House Jr. IRA
SECURED CONVERTIBLE PROMISSORY NOTE OFFERING
In September 2013, we commenced a private offering of $2,000,000 Secured
Convertible Promissory Notes in order to complete the purchase of the remaining
37.5% WI in the Five JABS property discussed earlier in the document. These
notes are due in September 2014 and are convertible into shares of our common
stock in whole or in part at a conversion price of $3.60 per share 6 months
after issuance of the secured convertible promissory note. The offering was not
fully subscribed and a total of $1,535,000 was raised.
NOTEHOLDER AMOUNT OF THE NOTE
-----------------------------------------------------------------------
Tincup Oil and Gas , LLC (1) $250,000
C. Roan Berry/Environtech Corp. $100,000
Timothy Dender $400,000
Dennis W. & Mary J. Gabriel $60,000
Charles Jones $100,000
Estate of William King $100,000
Estate of William King $500,000
Caroline J. Fisher, Ph. D $25,000
------------------------------------------------------------------------
(1) Mr. Ranew, a director of the Company, is a member of Tincup Oil and
Gas, LLC.
EXEMPTION FROM REGISTRATION CLAIMED
Sales and issuances by us of the unregistered securities listed above were made
by us in reliance upon Rule 506 of Regulation D to the individuals listed above.
All of the individuals and/or entities listed above that purchased the
unregistered securities were all known to us and our management, through
pre-existing business relationships, as long standing business associates,
friends, and employees. All purchasers were provided access to all material
information, which they requested, and all information necessary to verify such
information and were afforded access to our management in connection with their
purchases. All purchasers of the unregistered securities acquired such
securities for investment and not with a view toward distribution, acknowledging
such intent to us. All certificates or agreements representing such securities
that were issued contained restrictive legends, prohibiting further transfer of
the certificates or agreements representing such securities, without such
securities either being first registered or otherwise exempt from registration
in any further resale or disposition. Each purchaser made written representation
under Rule 506 of Regulation D, including net worth and sophistication. We
required written representation that each purchaser who was not an accredited
investor, either alone or with his purchaser representative, had such knowledge
and experience in financial and business matters that he/she was capable of
-11-
evaluating the merits and risks of the prospective investment, and the issuer
reasonably believed (based on written representations) immediately prior to
making any sale that the purchaser came within this description.
SHARES ISSUED FOR COMPENSATION OR SERVICES
Since our inception in March 2012 through June 30, 2013, we have issued a total
of 6,250,000 shares of our common stock in exchange for services to the
individuals and the amounts set forth below.
NUMBER OF SHARES CONSIDERATION NAME
--------------------------------------------------------------------------------
2,000,000 Services W Edward Nichols (1)
2,000,000 Services Donald Walford (1)
75,000 Services Lisa Baird
500,000 Services William Young (1)
750,000 Services Marc Pindus
150,000 Services Michael Littman
15,000 Services Debbie Hamen
15,000 Services Joe Ford
15,000 Services Herb Sears
200,000 Services Hawkeye Oil and Gas Ventures LLC
50,000 Services William Baber
10,000 Services Joe Ford
175,000 Services Prabhas Panigrahi
25,000 Services Paul Dragul (1)
270,000 Services Maxim Group Inc.
MATERIAL RELATIONSHIPS
(1) Director/Officer
EXEMPTION FROM REGISTRATION CLAIMED
All of the sales by us of the unregistered securities listed immediately above
were made by us in reliance upon Section 4(2) of the Act. All of the individuals
and/or entities listed above that purchased the unregistered securities were all
known to us and our management, through pre-existing business relationships, as
long standing business associates, friends, and employees. All purchasers were
provided access to all material information, which they requested, and all
information necessary to verify such information and were afforded access to our
management in connection with their purchases. All purchasers of the
unregistered securities acquired such securities for investment and not with a
view toward distribution, acknowledging such intent to us. All certificates or
agreements representing such securities that were issued contained restrictive
legends, prohibiting further transfer of the certificates or agreements
representing such securities, without such securities either being first
registered or otherwise exempt from registration in any further resale or
disposition.
-12-
ITEM 16. EXHIBITS AND FINANCIAL STATEMENT SCHEDULES
---------------------------------------------------
-------------- ------------------------------------------------------------------------ ---------------------------
EXHIBIT NO. DESCRIPTION
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).1 Articles of Incorporation of Three Forks, Inc. - 3/28/12 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).2 Articles of Organization of Three Forks No. 1, LLC - 11/8/2012 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).3 Articles of Incorporation of Three Forks Operating Company, Inc. - (1)
1/2/13
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).4 Articles of Amendment - Name Change to TFI Operating Company, Inc. - (1)
2/8/13
-------------- ------------------------------------------------------------------------ ---------------------------
3(i).5 Articles of Organization of Three Forks LLC No. 2 - 12/4/2013 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
3(ii).1 Bylaws of Three Forks, Inc. (1)
-------------- ------------------------------------------------------------------------ ---------------------------
3(ii).2 Bylaws of TFI Operating Company (fka Three Forks Operating Company, (1)
Inc.)
-------------- ------------------------------------------------------------------------ ---------------------------
5.1 Opinion re: Legality (2)
-------------- ------------------------------------------------------------------------ ---------------------------
10.1 Employment Agreement, Donald Walford (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.2 Amendment to Employment Agreement, Donald Walford (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.3 Consulting Agreement with W. Edward Nichols (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.4 Amendment to Consulting Agreement with W. Edward Nichols (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.5 Employment Agreement, Charles Pollard (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.6 Operating Agreement of Three Forks No. 1, LLC (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.7 Amendment to Operating Agreement of Three Forks No. 1, LLC (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.8 Certificate of Designation of Class A Convertible Preferred Stock (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.9 Stock Option Plan (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.10 Farmout Agreement (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.11 Purchase & Sale Agreement, Three Forks, Inc. & TFI No. 1, LLC 12/31/12 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.12 Purchase, Sale & Participation Agreement, Five Jab, Inc. & Three (2)
Forks, Inc. 2/27/13
-------------- ------------------------------------------------------------------------ ---------------------------
10.13 Blue Quail, Ltd. Participation Agreement 4/8/13 (1)
-------------- ------------------------------------------------------------------------ ---------------------------
10.14 1st Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc. 4/30/13
-------------- ------------------------------------------------------------------------ ---------------------------
-13-
10.15 2nd Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
10.16 3rd Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
10.17 4th Amendment to Purchase, Sale & Participation Agreement, Five Jab, (1)
Inc. & Three Forks, Inc.
-------------- ------------------------------------------------------------------------ ---------------------------
10.18 Form of Convertible Promissory Note & Mortgage, Security and Pledge (4)
Agreement
-------------- ------------------------------------------------------------------------ ---------------------------
10.19 Operating Agreement of Three Forks LLC No. 2 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
23.1 Consent of Attorney (2)
-------------- ------------------------------------------------------------------------ ---------------------------
23.2 Consent of Independent Registered Public Accounting Firm Filed Herewith
-------------- ------------------------------------------------------------------------ ---------------------------
99.1 Archer County, Texas picture, page 26 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
99.2 Pink Project, Pottawatamie County, Oklahoma picture, page 27 (2)
-------------- ------------------------------------------------------------------------ ---------------------------
101.INS XBRL Instance Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.SCH XBRL Taxonomy Extension Schema Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.CAL XBRL Taxonomy Extension Calculation Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.DEF XBRL Taxonomy Extension Definition Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.LAB XBRL Taxonomy Extension Label Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
101.PRE XBRL Taxonomy Extension Presentation Linkbase Document (2)(3)
-------------- ------------------------------------------------------------------------ ---------------------------
(1) Incorporated by reference from the exhibits included in the Company's Form
10-12g/A filed with the Securities and Exchange Commission (www.sec.gov),
filed October 29, 2013.
(2) Incorporated by reference from the exhibits included in the Company's Form
10-12G/A No. 2 filed with the Securities and Exchange Commission
(www.sec.gov), filed January 31, 2014.
(3) Pursuant to Rule 406T of Regulation S-T, this interactive data file is
deemed not filed or part of a registration statement or prospectus for
purposes of Sections 11 or 12 of the Securities Act of 1933, is deemed not
filed for purposes of Section 18 of the Securities Exchange Act of 1934,
and otherwise is not subject to liability under these sections.
(4) Incorporated by reference from the exhibits included in the Company's Form
10-12G/A No. 3 filed with the Securities and Exchange Commission
(www.sec.gov), filed February 18, 2014.
-14-
ITEM 17. UNDERTAKINGS
---------------------
We hereby undertake the following:
To file, during any period in which offers or sales are being made, a
post-effective amendment to this registration statement:
(a) To include any prospectus required by Section 10(a) (3) of the
Securities Act of 1933;
(b) To reflect in the prospectus any facts or events arising after the
effective date of this registration statement, or most recent
post-effective amendment, which, individually or in the aggregate,
represent a fundamental change in the information set forth in this
registration statement; and
(c) To include any material information with respect to the plan of
distribution not previously disclosed in this registration statement
or any material change to such information in the registration
statement.
That, for the purpose of determining any liability under the Securities Act,
each post-effective amendment shall be deemed to be a new registration statement
relating to the securities offered herein, and the offering of such securities
at that time shall be deemed to be the initial bona fide offering thereof.
To remove from registration by means of a post-effective amendment any of the
securities being registered hereby which remain unsold at the termination of the
Offering.
Insofar as indemnification for liabilities arising under the Securities Act may
be permitted to the directors, officers and controlling persons pursuant to the
provisions above, or otherwise, we have been advised that in the opinion of the
Securities and Exchange Commission such indemnification is against public policy
as expressed in the Securities Act, and is, therefore, unenforceable.
In the event that a claim for indemnification against such liabilities, other
than the payment by us of expenses incurred or paid by one of the directors,
officers, or controlling persons in the successful defense of any action, suit
or proceeding, is asserted by one of the directors, officers, or controlling
persons in connection with the securities being registered, we will unless in
the opinion of our counsel the matter has been settled by controlling precedent,
submit to a court of appropriate jurisdiction the question whether such
indemnification is against public policy as expressed in the Securities Act, and
we will be governed by the final adjudication of such issue.
For the purposes of determining liability under the Securities Act of 1933 to
any purchaser, if the Registrant is subject to Rule 430C, each prospectus filed
pursuant to Rule 424(b) as part of a registration statement relating to an
offering, shall be deemed to be part of and included in the registration
statement as of the date it is first used after effectiveness. Provided,
however, that no statement made in a registration statement or prospectus that
is part of the registration statement or made in a document incorporated or
deemed incorporated by reference into the registration statement or prospectus
that is part of the registration statement will, as to a purchaser with a time
of contract of sale prior to such first use, supersede or modify any statement
that was made in the registration statement or prospectus that was part of the
registration statement or made in any such document immediately prior to such
date of first use.
-15-
SIGNATURES
In accordance with the requirements of the Securities Act of 1933, the
registrant certifies that it has reasonable grounds to believe that it meets all
of the requirements for filing on Form S-1 and authorized this Registration
Statement to be signed on our behalf by the undersigned, thereunto duly
authorized, in the City of Broomfield, State of Colorado, on February 18, 2014.
THREE FORKS, INC.
/s/ W. Edward Nichols February 18, 2014
----------------------------------------------------------
W. Edward Nichols
(Chief Executive Officer and Principal Accounting Officer
and Principal Executive Officer)
In accordance with the requirements of the Securities Act of 1933, this
Registration Statement has been signed by the following persons in the
capacities and on the dates stated.
/s/ W. Edward Nichols February 18, 2014
----------------------------------------------------------
W. Edward Nichols, Chairman of the Board of Directors
/s/ Charles W. Pollard February 18, 2014
----------------------------------------------------------
Charles W. Pollard, Director
/s/ William F. Young February 18, 2014
----------------------------------------------------------
William F. Young, Director
/s/ Paul Dragul February 18, 2014
----------------------------------------------------------
Paul Dragul, Director
-16
