Sec Form 4 Filing - BASSHAM WAYNE ROBERT @ BEAR LAKE RECREATION INC - 2017-04-26

Insider filing report for Changes in Beneficial Ownership
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FORM 4
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP
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(h) of the Investment Company Act of 1940
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1. Name and Address of Reporting Person
BASSHAM WAYNE ROBERT
2. Issuer Name and Ticker or Trading Symbol
BEAR LAKE RECREATION INC [ BLKE]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
_____ Director _____ 10% Owner
_____ Officer (give title below) X __ Other (specify below)
Former President and director
(Last) (First) (Middle)
8867 SOUTH CAPELLA WAY
3. Date of Earliest Transaction (MM/DD/YY)
04/26/2017
(Street)
SANDY, UT84093
4. If Amendment, Date Original Filed (MM/DD/YY)
6. Individual or Joint/Group Filing (Check Applicable Line)
__ X __ Form filed by One Reporting Person
_____ Form filed by More than One Reporting Person
(City) (State) (Zip)
Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned
1.Title of Security
(Instr. 3)
2. Transaction Date (MM/DD/YY) 2A. Deemed Execution Date, if any (MM/DD/YY) 3. Transaction Code
(Instr. 8)
4. Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4 and 5)
5. Amount of Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 3 and 4)
6. Ownership Form: Direct (D) or Indirect (I)
(Instr. 4)
7. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V Amount (A) or (D) Price
Common Stock 04/26/2017 S 181,634 ( 2 ) D $ 0.022 104,082 ( 1 ) D
Common Stock 04/26/2017 S 82,416 ( 3 ) D $ 0.02 21,666 D
Common Stock 04/26/2017 S 6,666 ( 4 ) D $ 0.02 15,000 ( 5 ) D
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned
( e.g. , puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security
(Instr. 3)
2. Conversion or Exercise Price of Derivative Security 3. Transaction Date (MM/DD/YY) 3A. Deemed Execution Date, if any (MM/DD/YY) 4. Transaction Code
(Instr. 8)
5. Number of Derivative Securities Acquired (A) or Disposed of (D)
(Instr. 3, 4, and 5)
6. Date Exercisable and Expiration Date
(MM/DD/YY)
7. Title and Amount of Underlying Securities
(Instr. 3 and 4)
8. Price of Derivative Security
(Instr. 5)
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s)
(Instr. 4)
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I)
(Instr. 4)
11. Nature of Indirect Beneficial Ownership
(Instr. 4)
Code V (A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Reporting Owners
Reporting Owner Name / Address Relationships
Director 10% Owner Officer Other
BASSHAM WAYNE ROBERT
8867 SOUTH CAPELLA WAY
SANDY, UT84093
Former President and director
Signatures
/s/ Wayne Bassham 04/27/2017
Signature of Reporting Person Date
Explanation of Responses:
( 1 )These shares reflect a 3.5 for 1 reverse stock split effective October 23, 2006. The previous ownership reported was 1,000,000 shares beneficially owned, which after the reverse and rounding equals 285,716 shares beneficially owned.
( 2 )181,634 shares were cancelled to the Company for an aggregate price of $4,000 pursuant to a Common Stock Purchase Agreement dated April 5, 2017 (the "Agreement"), and filed with the Securities and Exchange Commission on that date; the Agreement was closed and completed on April 26, 2017, at which time Mr. Bassham's resignation as an officer and director of the Company became effective.
( 3 )Mr. Bassham sold 82,416 shares to a person who may be deemed to have been a related party of the Company at $0.02 per share for an aggregate purchase price of $1,648.32.
( 4 )Mr. Bassham also sold 6,666 shares to a former legal counsel of the Company at $0.02 per share for an aggregate purchase price of $133.32.
( 5 )The Agreement required that the remaining 15,000 shares owned by Mr. Bassham be pledged to the Company for a period of 12 months under an Indemnification Escrow Agreement and an Indemnification Agreement.

Remarks:
The Agreement required that the remaining 15,000 shares owned by Mr. Bassham be pledged to the Company for a period of 12 months under an Indemnification Escrow Agreement and an Indemnification Agreement.

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* If the form is filed by more than one reporting person, see Instruction 4(b)(v).
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