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F O R M 3 UNITED STATES SECURITIES AND EXCHANGE COMMISSION OMB Approval
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OMB Number 3235-014
Expires: December 31, 2001
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Estimated average burden
hours per response........0.5
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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(Print or Type Responses)
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1..Name and Address of Reporting Person* | 2. Date of Event 4. Issuer Name and Ticker or Trading Symbol
| Requiring Statement
| (Month/Day/Year) GREKA Energy Corporation GRKA
9/9/97
Grewal Randeep S.
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(Last) (First) (Middle)
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
10815 Briar Forest Drive
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(Street) ------- -------
Officer (give Other (specify
--------------------------- X title below) below)
3. I.R.S. Identification ------- -------
Houston TX 77042 Number of Reporting
- ---------------------------------------------------- Person, if an entity Chief Executive Officer
(City) (State) (Zip) (Voluntary) ---------------------------------------
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6. If Amendment, Date of Original 7. Individual or Joint/Group
(Month/Day/Year) (Check Applicable Line)
Form filed by One
10/20/97 X Reporting Person
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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 2. Amount of Securities 3. Ownership 4. Nature of Indirect Beneficial
(Instr. 4) Beneficially Owned Form: Direct (D) or Indirect Ownership (Instr. 5)
(Instr. 4) (I) (Instr. 5)
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Common Stock, no par value 70,000* D
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Over)
* If the form is filed by more than one reporting person, see Instruction 5(b)(v). SEC 1473 (3-99)
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F O R M 3 (continued) Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options,
convertible securities)
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1. Title of Derivative 2. Date Exercisable and 3. Title and Amount of 4. Conversion 5. Ownership 6. Nature of
Security (Instr. 4) Expiration Date Securities Underlying or Exercise Form of Indirect
(Month/Day/Year) Derivative Security Price of Derivative Beneficial
(Instr. 4) Derivative Security: Ownership
Security Direct (D) (Instr. 5)
or Indirect
(I) (Instr. 5)
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Date Expiration Amount or
Exercisable Date Title Number of Shares
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Employee Stock Option
(right to buy) 10/14/98 9/9/2007 Common Stock 150,000 $5.00 D
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Explanation of Responses:
* Mr. Grewal has the right to receive these shares as of September 9, 1997 but
they were not issued until October 15, 1997.
/s/ Randeep S. Grewal November 17, 1999
** Intentional misstatements or omissions of facts constitute Federal Criminal ------------------------------- -----------------
Violations. **Signature of Reporting Person Date
See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a)
Note: File three copies of this Form, one of which must be manually signed.
If space is insufficient, See Instruction 6 for procedure.
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 Number.
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