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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1. Name and Address of Reporting Person*
Maxim Kelyfos LLC

(Last) (First) (Middle)
99 SUNNYSIDE BLVD.

(Street)
WOODBURY NY 11797

(City) (State) (Zip)
2. Date of Event Requiring Statement (Month/Day/Year)
10/11/2010
3. Issuer Name and Ticker or Trading Symbol
PinstripesNYS, Inc. [ NONE ]
4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director X 10% Owner
X Officer (give title below) Other (specify below)
President
5. If Amendment, Date of Original Filed (Month/Day/Year)
6. Individual or Joint/Group Filing (Check Applicable Line)
Form filed by One Reporting Person
X Form filed by More than One Reporting Person
Table I - Non-Derivative Securities Beneficially Owned
1. Title of Security (Instr. 4) 2. Amount of Securities Beneficially Owned (Instr. 4) 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 4. Nature of Indirect Beneficial Ownership (Instr. 5)
Common Stock par value $.0001 per share (the "Common Stock") 5,000,000 D
Common Stock par value $.0001 per share (the "Common Stock") 5,000,000 I See Footnote(1)
Common Stock par value $.0001 per share (the "Common Stock") 5,000,000 I See Footnote(2)
Common Stock par value $.0001 per share (the "Common Stock") 3,613,500 I See Footnote(3)
Table II - Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
1. Title of Derivative Security (Instr. 4) 2. Date Exercisable and Expiration Date (Month/Day/Year) 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) 4. Conversion or Exercise Price of Derivative Security 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) 6. Nature of Indirect Beneficial Ownership (Instr. 5)
Date Exercisable Expiration Date Title Amount or Number of Shares
1. Name and Address of Reporting Person*
Maxim Kelyfos LLC

(Last) (First) (Middle)
99 SUNNYSIDE BLVD.

(Street)
WOODBURY NY 11797

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Teller Clifford

(Last) (First) (Middle)
99 SUNNYSIDE BLVD.

(Street)
WOODBURY NY 11797

(City) (State) (Zip)
1. Name and Address of Reporting Person*
Maxim Partners LLC

(Last) (First) (Middle)
99 SUNNYSIDE BLVD.

(Street)
WOODBURY NY 11797

(City) (State) (Zip)
1. Name and Address of Reporting Person*
MJR Holdings LLC

(Last) (First) (Middle)
99 SUNNYSIDE BLVD.

(Street)
WOODBURY NY 11797

(City) (State) (Zip)
Explanation of Responses:
1. Represents the shares of Common Stock owned of record by Maxim Kelyfos LLC ("Maxim Kelyfos") and beneficially by Maxim Partners LLC ("Maxim Partners"). Maxim Partners owns 100% of the outstanding membership interests of Maxim Kelyfos and may be deemed to be the indirect beneficial owner of the securities held by Maxim Kelyfos.
2. Represents the shares of Common Stock owned of record by Maxim Kelyfos LLC ("Maxim Kelyfos") and beneficially by Clifford Teller, the Issuer's President and a director. Mr. Teller is a Principal of Maxim Partners, the parent of Maxim Kelyfos and may be deemed to beneficially own the shares of Common Stock held by Maxim Kelyfos
3. Represents 72.27% of the shares of Common Stock owned of record by Maxim Kelyfos and beneficially by MJR Holdings LLC. MJR Holdings owns 72.27% of the outstanding membership interests of Maxim Partners and therefore may be deemed to beneficially own up to 72.27% of the shares of Common Stock owned of record by Maxim Kelyfos.
Remarks:
/s/ Clifford Teller 10/11/2010
/s/ Clifford Teller, Principal of Maxim Kelyfos, LLC 10/11/2010
/s/ Edward L. Rose, Member of MJR Holdings, LLC 10/11/2010
/s/ Edward L. Rose, Principal of Maxim Partners LLC 10/11/2010
** 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).
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