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FORM 4
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UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
[ ] Check this box if no longer subject to Section 16. Form 4 or Form 5
obligations may continue. See Instruction 1(b).
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*
Petersen Randy
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(Last) (First) (Middle)
1520 E. Pima Street
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(Street)
Phoenix AZ 85034
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(City (State) (Zip)
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2. Issuer Name and Ticker or Trading Symbol
SkyMall, Inc.; SKYM
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3. I.R.S. Identification
Number of Reporting
Person, if an entity
(Voluntary)
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4. Statement for Month/Year
December 1999
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5. If Amendment,
Date of Original
(Month/Year)
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6. 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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7. 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>
<CAPTION>
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TABLE I--NON-DERIVATIVE SECURITIES ACQUIRED, DISPOSED OF, OR BENEFICIALLY OWNED
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1. Title of Security 2. Trans- 3. Trans- 4. Securities Acquired (A) 5. Amount of 6. Owner- 7. Nature of
(Instr. 3) action action or Disposed of (D) Securities ship Indirect
Date Code (Instr. 3, 4 and 5) Beneficially Form: Beneficial
(Instr. 8) Owned at Direct Owner-
(Month/ ---------- ------------------------------- End of Month (D) or ship
Day/ (A) or Indirect
Year) Code V Amount (D) Price (Instr. 3 and 4) (I)
(Instr. 4) (Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C> <C>
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</TABLE>
Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
* If the form is filed by more than one reporting person, see Instruction
4(b)(v).
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.
<PAGE>
Form 4 (continued)
<TABLE>
<CAPTION>
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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 Derivative Security 2. Conver- 3. Trans- 4. Transac- 5. Number of Deriv-
(Instr. 3) sion or action tion ative Securities Ac-
Exercise Date Code quired (A) or Dis-
Price of (Instr. 8) posed of (D)
Deri- (Month/ (Instr. 3,4, and 5)
vative Day/ ----------- -------------------------
Security Year) Code V (A) (D)
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<S> <C> <C> <C> <C> <C> <C>
Series A Junior Convertible
Preferred Stock(1) (2) 12/22/99 P 250
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Warrants to Purchase
Common Stock(1) (3) 12/22/99 P 1,786
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<CAPTION>
6. Date Exer- 7. Title and Amount of 8. Price 9. Number 10. Owner- 11. Nature
cisable and Underlying Securities of of Deriv- ship of
Expiration (Instr. 3 and 4) Deriv- ative Form of Indirect
Date ative Secur- Deriv- Benefi-
(Month/Day/ Secur- ities ative cial
Year) ity Bene- Security: Owner-
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Date Expira- Amount or 5) Owned (D) or (Instr. 4)
Exer- tion Title Number of at End Indirect
cisable Date Shares of (I)
Month (Instr. 4)
(Instr. 4)
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<S> <C> <C> <C> <C> <C> <C> <C>
(2) (2) Common Stock 3,571 (1) 250 D
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(3) (3) Common Stock 1,786 (1) 1,786 D
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</TABLE>
Explanation of Responses:
(1) Securities were purchased as units, at a purchase price of $7.00 per unit,
pursuant to a Stock and Warrant Purchase Agreement dated as of December 20,
1999, each unit consisting of shares of Series A Convertible Preferred
Stock and Warrants to purchase shares of Common Stock.
(2) The Series A Junior Convertible Preferred Stock is automatically
convertible into shares of common stock upon the approval such conversion
and issuance by the shareholders of SkyMall. Each share of Series A Junior
Convertible Preferred Stock is convertible into an amount of common stock
equal to a conversion ratio of: (1) a liquidation preference of $100 plus
any penalties divided by (2) $7.00, and is subject adjustment in certain
circumstances. If shareholder approval of the conversion of the Series A
Junior Convertible Preferred Stock and issuance of the common stock upon
conversion is not received on or before June 16, 2000, the Company must
redeem all the outstanding shares of the Series A Junior Convertible
Preferred Stock at an amount equal to 110% of the liquidation preference
plus any penalties.
(3) The Warrants expire five years after issuance and may be exercised at any
time after issuance. The exercise price of each warrant is $8.00 per share
of common stock represented by the warrant and is subject to customary
anti-dilution adjustments in certain circumstances.
/s/ Randy Petersen January 10, 2000
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**Signature of Reporting Person Date
Randy Petersen
**Intentional misstatements or omissions of facts constitute Federal Criminal
Violations. 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.
Page 2
SEC 1474 (7/97)
