SEC FORM 5 SEC Form 5
FORM 5 UNITED STATES SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549

ANNUAL STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP

Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934
or Section 30(h) of the Investment Company Act of 1940
OMB APPROVAL
OMB Number: 3235-0362
Estimated average burden
hours per response: 1.0
  
Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b).
  
Form 3 Holdings Reported.
  
Form 4 Transactions Reported.
1. Name and Address of Reporting Person*
SMITH D PAUL

(Last) (First) (Middle)
350 W BROADWAY
STE 100

(Street)
SALT LAKE CITY UT 84101

(City) (State) (Zip)
2. Issuer Name and Ticker or Trading Symbol
KLEVER MARKETING INC [ KLMK ]
5. Relationship of Reporting Person(s) to Issuer
(Check all applicable)
X Director 10% Owner
X Officer (give title below) Other (specify below)
CFO
3. Statement for Issuer's Fiscal Year Ended (Month/Day/Year)
12/31/2003
4. 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 Acquired, Disposed of, or Beneficially Owned
1. Title of Security (Instr. 3) 2. Transaction Date (Month/Day/Year) 2A. Deemed Execution Date, if any (Month/Day/Year) 3. Transaction Code (Instr. 8) 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) 5. Amount of Securities Beneficially Owned at end of Issuer's Fiscal Year (Instr. 3 and 4) 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) 7. Nature of Indirect Beneficial Ownership (Instr. 4)
Amount (A) or (D) Price
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 (Month/Day/Year) 3A. Deemed Execution Date, if any (Month/Day/Year) 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 (Month/Day/Year) 7. Title and Amount of Securities Underlying Derivative Security (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: Direct (D) or Indirect (I) (Instr. 4) 11. Nature of Indirect Beneficial Ownership (Instr. 4)
(A) (D) Date Exercisable Expiration Date Title Amount or Number of Shares
Stock Option $1 04/10/2002 04/10/2002 J 25,000 04/10/2002 04/10/2005 Common 25,000 $1 1,261,225 D
Stock Option $1 08/30/2002 08/30/2002 J 617 08/30/2002 08/30/2005 Common 617 $1 1,261,225 D
Stock Option $1 11/01/2002 11/01/2002 J 608 11/01/2002 11/01/2005 Common 608 $1 1,261,225 D
Stock Option $1 11/04/2002 11/04/2002 J 25,000 11/04/2002 11/04/2005 Common 25,000 $1 1,261,225 D
Stock Option $1 12/31/2002 12/31/2002 J 41,667 12/31/2002 12/31/2005 Common 41,667 $1 1,261,225 D
Stock Option $1 02/21/2003 02/21/2003 J 8,333 02/21/2003 02/21/2006 Common 8,333 $1 1,261,225 D
Stock Option $1 03/31/2003 03/31/2003 J 25,000 03/31/2003 03/31/2006 Common 25,000 $1 1,261,225 D
Stock Option $1 07/18/2003 07/18/2003 J 12,500 07/18/2003 07/18/2006 Common 12,500 $1 1,261,225 D
Stock Option $1 08/18/2003 08/18/2003 J 8,333 08/18/2003 08/18/2006 Common 8,333 $1 1,261,225 D
Stock Option $1 10/08/2003 10/08/2003 J 4,167 10/08/2003 10/08/2006 Common 4,167 $1 1,261,225 D
Stock Option $0.06 09/09/2003 09/09/2003 J 300,000 09/09/2003 09/09/2007 Common 300,000 $0.06 1,261,225 D
Stock Option $0.06 09/12/2003 09/12/2003 J 600,000 09/12/2003 09/09/2007 Common 600,000 $0.06 1,261,225 D
Stock Option $2.75 09/09/2003 09/09/2003 J 10,000 09/09/2003 09/09/2003 Common 10,000 $2.75 1,261,225 D
Stock Option $1 09/09/2003 09/09/2003 J 100,000 09/09/2003 09/09/2003 Common 100,000 $1 1,261,225 D
Stock Option $1.05 09/09/2003 09/09/2003 J 100,000 09/09/2003 09/09/2003 Common 100,000 $1.05 1,261,225 D
Stock Option $0.06 09/09/2003 09/09/2003 J 10,000 09/09/2003 09/09/2007 Common 10,000 $0.06 1,261,225 D
Stock Option $0.06 09/09/2003 09/09/2003 J 100,000 09/09/2003 09/09/2007 Common 100,000 $0.06 1,261,225 D
Stock Option $0.06 09/09/2003 09/09/2003 J 100,000 09/09/2003 09/09/2007 Common 100,000 $0.06 1,261,225 D
Explanation of Responses:
D. Paul Smith 03/29/2004
** 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 4 (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).
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure.
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number.