Statement of Changes in Beneficial Ownership (4)
January 12 2015 - 12:26PM
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
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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
*
PALETHORPE MICHAEL HARDY
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2. Issuer Name
and
Ticker or Trading Symbol
NEW MEDIA INSIGHT GROUP, INC.
[
NMED
]
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5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
__
X
__ Director
__
X
__ 10% Owner
__
X
__ Officer (give title below)
_____ Other (specify below)
President,CEO, CFO & Secretary
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(Last)
(First)
(Middle)
28202 N 58TH STREET
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3. Date of Earliest Transaction
(MM/DD/YYYY)
5/1/2013
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(Street)
CAVE CREEK, AZ 85331
(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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0
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D
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Common Stock
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8/8/2014
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P
(1)
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8500000
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A
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$0.001
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8500000
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D
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Common Stock
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9/8/2014
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P
(1)
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8500000
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A
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$0.001
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17000000
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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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Stock Options
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$0.75
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5/1/2013
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J
(2)
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500000
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11/30/2013
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11/30/2016
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Common Stock
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500000
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$1.6
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500000
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D
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Stock Options
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$0.75
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1/1/2014
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J
(2)
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1125
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1/1/2014
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1/1/2017
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Common Stock
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1125
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$1.6
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501125
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D
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Stock Options
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$0.75
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2/1/2014
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J
(2)
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1125
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2/1/2014
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2/1/2017
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Common Stock
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1125
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$1.6
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502250
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D
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Stock Options
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$0.75
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3/1/2014
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J
(2)
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1125
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3/1/2014
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3/1/2017
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Common Stock
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1125
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$1.6
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503375
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D
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Stock Options
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$0.75
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4/1/2014
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J
(2)
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1125
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4/1/2014
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4/1/2017
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Common Stock
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1125
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$1.6
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504500
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D
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Explanation of Responses:
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(
1)
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Acquired 8,500,000 restricted common shares from a previous stockholder in exchange for $10,000.
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(
2)
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On April 1, 2013, we entered into an agreement with Mr. Palethorpe, effective May 1, 2013. Pursuant to the agreement, he will serve as our President and CEO in exchange for:
1. $6,000 per month; and
2. $6,000 per month in our common stock.
He is also entitled to a stock option grant equal to 30% of his salary granted at the beginning of the year and vest equally over the year. The price of the options will be the FMV of our stock at the time the options are granted, exercisable into a common share at $0.75 and will expire after 3 years. Further, he is to receive 2,000,000 stock options vesting at the rate of 500,000 options every 6 months at an exercise price of $0.75 per share and expire after 3 years. On May 1, 2014, we entered into an amending agreement whereby we agreed to renew his agreement and suspend the grant of $6,000 in common stock. The vesting of stock options and the remainder of his 2,000,000 options have also been suspended as of April 30, 2014.
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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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PALETHORPE MICHAEL HARDY
28202 N 58TH STREET
CAVE CREEK, AZ 85331
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X
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X
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President,CEO, CFO & Secretary
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Signatures
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/s/Michael Palethorpe
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1/12/2015
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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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