SEC FORM
3
SEC Form 3
| FORM 3 |
UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549
INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES
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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| OMB APPROVAL |
| OMB Number: |
3235-0104 |
| Estimated average burden |
| hours per response: |
0.5 |
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1. Name and Address of Reporting Person*
(Street)
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2. Date of Event Requiring Statement
(Month/Day/Year) 09/19/2006
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3. Issuer Name and Ticker or Trading Symbol
POKERTEK INC
[ PTEK ]
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4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
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Director |
X |
10% Owner |
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Officer (give title below) |
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Other (specify below) |
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5. If Amendment, Date of Original Filed
(Month/Day/Year)
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6. Individual or Joint/Group Filing (Check Applicable Line)
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Form filed by One Reporting Person |
| X |
Form filed by More than One Reporting Person |
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| Table I - Non-Derivative Securities Beneficially Owned |
| 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 |
1,396,800
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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 Derivative Security (Instr.
4)
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2. Date Exercisable and Expiration Date
(Month/Day/Year) |
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: 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 |
Expiration Date |
Title |
Amount or Number of Shares |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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| Explanation of Responses: |
| Remarks: |
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/s/ Bruce J. Yahl, Bruce J. Yahl, as Secretary of Aristocrat International Pty. Limited for Aristocrat International Pty. Limited |
09/22/2006 |
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/s/ Bruce J. Yahl, Bruce J. Yahl, as Secretary of Aristocrat Leisure Limited for Aristocrat Leisure Limited |
09/22/2006 |
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** Signature of Reporting Person |
Date |
| 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
5
(b)(v). |
| ** 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. |
| 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 Number. |
EXHIBIT 99.1
FORM 3 JOINT FILER INFORMATION
NAME: ARISTOCRAT LEISURE LIMITED
RELATIONSHIP OF REPORTING PERSON TO ISSUER: 10% BENEFICIAL OWNER
ADDRESS: 71 LONGUEVILLE ROAD LANE COVE, NSW 2066 AUSTRALIA
DESIGNATED FILER: ARISTOCRAT INTERNATIONAL PTY. LIMITED
ISSUER AND TICKER SYMBOL: POKERTEK INC [PTEK]
DATE OF EVENT REQUIRING STATEMENT: 09/19/2006
SIGNATURE: /s/ BRUCE J. YAHL
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BRUCE J. YAHL
SECRETARY OF ARISTOCRAT LEISURE LIMITED