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OMB APPROVAL
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------ OMB Number 3235-0104
FORM 3 Expires: December 31, 2001
------ Estimated average burden
hours per response ....... 0.5
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U.S. 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
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1. Name and Address of Reporting Person
Brotherson Gaylen M.
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(Last) (First) (Middle)
9419 E. San Salvador, Suite 105
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(Street)
Scottsdale AZ 85258
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(City) (State) (Zip)
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2. Date of Event Requiring Statement (Month/Day/Year)
6/27/01
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3. IRS or Social Security Number of Reporting Person (Voluntary)
482-46-4919
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4. Issuer Name and Ticker or Trading Symbol
MBA Holdings, Inc. MBAI
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5. Relationship of Reporting Person to Issuer (Check all applicable)
[X] Director [X] 10% Owner
[X] Officer (give title below) [ ] Other (specify below)
CEO
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6. If Amendment, Date of Original (Month/Year)
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7. Individual or Joint/Group Filing (Check Applicable Line)
[X] Form filed by One Reporting Person
[ ] Form filed by More than One Reporting Person
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FORM 3 (continued)
Table I -- Non-Derivative Securities Beneficially Owned
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3. Ownership Form:
1. Title of 2. Amount of Securities Direct (D) or 4. Nature of Indirect
Security Beneficially Owned Indirect (I) Beneficial Ownership
(Instr. 4) (Instr. 4) (Instr. 5) (Instr.5)
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Common Stock 930,815 D
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Reminder: Report on a separate line for each class of securities beneficially
owned directly or indirectly.
Table II -- Derivative Securities Beneficially Owned
(e.g., puts, calls, warrants, options, convertible securities)
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3. Title and Amount of
Securities Underlying 5. Owner-
Derivative Security ship
2. Date Exercisable (Instr. 4) Form of
and Expiration Date ----------------------- 4. Conver- Derivative
(Month/Day/Year) Amount sion or Security: 6. Nature of
1.Title of -------------------- or Exercise Direct Indirect
Derivative Date Expira- Number Price of (D) or Beneficial
Security Exer- tion of Derivative Indirect(I) Ownership
(Instr. 4) cisable Date Title Shares Security (Instr.5) (Instr. 5)
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N/A
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Explanation of Responses:
/s/ Gaylen M. Brotherson 7-12-2001
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**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).