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 Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 _______________________________________________________________________________ 1. Name and Address of Reporting Person Hefferon Fred ____________________________________________________ (Last) (First) (Middle) 1981 E Murray-Holladay Rd ____________________________________________________ (Street) Salt Lake City, Utah 84117 ____________________________________________________ (City) (State) (Zip) _______________________________________________________________________________ 2. Date of Event Requiring Statement 06/19/2000 ____________________________________________________ (Month/Day/Year) _______________________________________________________________________________ 3. I.R.S. Identification Number of Reporting Person, if and entity (voluntary) _______________________________________________________________________________ 4. Issuer Name and Ticker or Trading Symbol Western Glory Hole, Inc. WSGH _______________________________________________________________________________ 5. Relationship of Reporting Person(s) to Issuer (Check all applicable) (X) Director ( ) 10% Owner (X) Officer (give title below) ( ) Other (specify title below) President ____________________________________________________ _______________________________________________________________________________ 6. If Amendment, Date of Original ____________________________________________________ (Month/Day/Year) _______________________________________________________________________________ 7. Individual or Joint/Group Filing (Check Applicable Line) X Form Filed by One Reporting Person - -- __ Form filed by More than One Reporting Person ===============================================================================
TABLE I - NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED 1.Title of Security 2. Amount of 3. Ownership 4. Nature of Indirect (Instr. 4) Securities Form: Direct Beneficial Ownership Beneficially Owned (D) or Indirect (Instr.5) (Instr. 4) (I) (Instr. 5) Common Stock 12,500 (D) Direct N/A
=============================================================================== TABLE II - DERIVATIVE SECURITIES BENEFICIALLY OWNED (E.G., PUTS, CALLS, WARRANTS, OPTIONS, CONVERTIBLE SECURITIES) _______________________________________________________________________________ 1. Title of Derivative Security (Instr. 4) NONE _______________________________________________________________________________ 2. Date of Exercisable and Expiration Date (Month/Day/Year) _________________ ___________________ Date Exercisable Expiration Date _______________________________________________________________________________ 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) ____________________________________________________ Title Amount or Number of Shares _______________________________________________________________________________ 4. Conversion or Exercise Price of Derivative Security _______________________________________________________________________________ 5. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 5) _______________________________________________________________________________ 6. Nature of Indirect Beneficial Ownership (Instr. 5) _______________________________________________________________________________ EXPLANATION OF RESPONSES: /s/ Fred Hefferon 6-6-00 ------------------------------------------- --------- **Signature of Reporting Person Date _______________________________________________________________________________ **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.