Highlands Acquisition Corp - Initial Statement of Beneficial Ownership (3)
04 October 2007 - 6:15AM
Edgar (US Regulatory)
FORM 3
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0104
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January 31, 2008
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Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
CAMPBELL WILLIAM V
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2. Date of Event Requiring Statement (MM/DD/YYYY)
10/3/2007
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3. Issuer Name
and
Ticker or Trading Symbol
Highlands Acquisition Corp [HIA.U]
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(Last)
(First)
(Middle)
2421 PARK BOULEVARD, SUITE 202B
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4. 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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(Street)
PALO ALTO, CA 94306
(City)
(State)
(Zip)
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5. 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 Beneficially Owned
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1.Title of Security
(Instr. 4)
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2. Amount of Securities Beneficially Owned
(Instr. 4)
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3. Ownership Form: Direct (D) or Indirect (I)
(Instr. 5)
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4. Nature of Indirect Beneficial Ownership
(Instr. 5)
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Common Stock
(1)
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20700
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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. 4)
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2. Date Exercisable and Expiration Date
(MM/DD/YYYY)
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3. Title and Amount of Securities Underlying Derivative Security
(Instr. 4)
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4. Conversion or Exercise Price of Derivative Security
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5. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 5)
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6. Nature of Indirect Beneficial Ownership
(Instr. 5)
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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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Warrants
(1)
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(2)
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10/2/2012
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Common Stock
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20700
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$7.50
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D
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Explanation of Responses:
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(
1)
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These securities are included in units, each unit consisting of one share of common stock and one warrant each to purchase one share of common stock. 2,700 units are subject to forfeiture to the extent that the underwriters over-allotment option in the Company's initial public offering is not exercised in full or expires unexercised.
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(
2)
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The warrants will become exercisable upon the later of the completion of a business combination with a target business and January 3, 2009; provided that the last sales price of the Company's common stock exceeds $14.25 per share for any 20 trading days within a 30-trading day period beginning 90 days after the consummation of a business combination.
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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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CAMPBELL WILLIAM V
2421 PARK BOULEVARD
SUITE 202B
PALO ALTO, CA 94306
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X
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Signatures
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/s/ William V. Campbell
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10/3/2007
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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 5(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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