Orthometrix Inc - Annual Statement of Changes in Beneficial Ownership (5)
22 February 2008 - 9:35AM
Edgar (US Regulatory)
FORM 5
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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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Form 3 Holdings Reported
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Form 4 Transactions Reported
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES
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OMB APPROVAL
OMB Number:
3235-0362
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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(f) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
*
BONMATI REYNALD G
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2. Issuer Name
and
Ticker or Trading Symbol
ORTHOMETRIX INC [OMRX.PK]
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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 & Chairman
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(Last)
(First)
(Middle)
SPANISH MOSS TRAIL
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3. Statement for Issuer's Fiscal Year Ended
(MM/DD/YYYY)
12/31/2007
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(Street)
NAPLES, FL 34108
(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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Amount
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(A) or (D)
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Price
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Common Stock, Par Value $0.0005
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8/29/2007
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P
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25000
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A
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$0.03
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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8/30/2007
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P
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25000
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A
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$0.04
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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9/9/2007
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P
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25000
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A
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$0.045
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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9/21/2007
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P
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25000
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A
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$0.05
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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9/24/2007
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P
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25000
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A
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$0.05
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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11/19/2007
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P
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37953
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A
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$0.03
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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11/21/2007
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P
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30000
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A
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$0.04
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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11/26/2007
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P
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50000
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A
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$0.045
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Common Stock, Par Value $0.0005
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12/4/2007
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P
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30000
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A
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$0.04
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22088760
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I
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SEE FOOTNOTES (1,2)
(1)
(2)
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Table II - Derivative Securities Acquired, Disposed of, or 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
(MM/DD/YYYY)
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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 at End of Issuer's Fiscal Year
(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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(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 Option
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$0.02
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8/16/2007
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M
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45000
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8/16/2007
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8/16/2007
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Common Stock
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45000
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$0.02
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961250
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I
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SEE FOOTNOTES (1,2)
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Explanation of Responses:
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(
1)
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The amount of securities beneficially owned by the reporting person includes the aggregate number of shares indirectly owned by the reporting person, which includes 13,449,499 shares of the issuer's common stock held by Bones, LLC, of which the reporting person is a managing member. The aggregate number of shares is reported under SEC Rules and Staff Interpretations, although the number includes shares in which the reporting person does not have a pecuniary interest.
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(
2)
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The reporting person disclaims beneficial ownership of 1,562,638 shares of the issuer's common stock. In filing this Form-5 and reporting the information contained herein, the undersigned is not admitting to or conceding beneficial ownership of any securities of rights described herein pursuant to Sections 13 or 16 of The Securities Exchange Act of 1934, as amended, or any rule or regulation promulgated hereunder. 1,361,638 shares are owned by the reporting person's wife, as trustee of two trusts benefitting their children, The Sandrine Bonmati Trust and The Chrystele Bonmati Trust with respect to which the reporting person disclaims beneficial ownership. The Sandrine Bonmati Trust held a total of 531,600 shares of the issuer's common stock on December 31,2007. The Chrystele Bonmati Trust held 830,038 shares on December 31,2007. A total of 201,000 shares are owned by the reporting person's grandchildren on December 31,2007, to which the reporting person disclaims beneficial ownership.
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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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BONMATI REYNALD G
SPANISH MOSS TRAIL
NAPLES, FL 34108
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X
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X
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President & Chairman
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Signatures
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Reynald Bonmati
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2/21/2008
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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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