Timberline Resources (TLRS) Form 3 Timberline Resources / William Fuller Matlack ownership change

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^*

Matlack William Fuller

(Last) (First) (Middle)

C/O TIMBERLINE RESOURCES CORPORATION

101 EAST LAKESIDE AVENUE

(Street)

COEUR D'ALENE ID 83814

(City) (State) (Zip)

2. Date of Event Requiring Statement (Month/Day/Year)
10/23/2019

3. Issuer Name and Ticker or Trading Symbol
Timberline Resources Corp [ TLRS ]

4. Relationship of Reporting Person(s) to Issuer
(Check all applicable)

X	Director	X	10% Owner
	Officer (give title below)		Other (specify below)

5. If Amendment, Date of Original Filed (Month/Day/Year)

6. 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 (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	13,021,679	D

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
Series D Warrants	09/09/2018(1)	04/30/2021	Common shares	2,025,000	0.14	D
Series I Warrants	11/09/2019(1)	11/07/2020	Common shares	3,543,600	0.07	D
Series J Warrants	02/24/2020(1)	10/15/2024	Common shares	3,562,500	0.12	D
Series K Warrants	04/08/2020(1)	01/20/2023	Common shares	4,000,000	0.08	D
Stock options	10/29/2019	10/29/2024	Common shares	404,348	0.08	D
Series E Warrants	03/09/2019(1)	10/29/2021	Common shares	3,678,979	0.08	D

Explanation of Responses:

1. Warrants may not be exercised, except within 61 days of expiration, if such exercise would cause holder to beneficially own or exercise control or direction over 9.99% or greater of the issued and outstanding voting shares of the issuer. Warrants may not be exercised if such exercise would cause holder to beneficially own or exercise control or direction over 19.99% or greater of the issued and outstanding voting shares of the issuer.

	William Matlack	01/10/2020
	** 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).
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