ACCESSION NUMBER:
CONFORMED SUBMISSION TYPE: SC 13D
PUBLIC DOCUMENT COUNT: 1
FILED AS OF DATE: 20090416
DATE AS OF CHANGE: 20090416
SUBJECT COMPANY:
COMPANY DATA:
COMPANY CONFORMED NAME: Capital Source Healthcare REIT
CENTRAL INDEX KEY: 0001438355
STANDARD INDUSTRIAL CLASSIFICATION: [6798]
IRS NUMBER: 262730129
STATE OF INCORPORATION:
FISCAL YEAR END: 1231
FILING VALUES:
FORM TYPE: SC 13D
SEC ACT: 1934 Act
SEC FILE NUMBER: 001-34194
FILM NUMBER:
BUSINESS ADDRESS:
STREET 1: 30699 RUSSELL RANCH ROAD. SUITE 200
CITY: WESTLAKE VILLAGE
STATE: CALIFORNIA
ZIP: 91362
BUSINESS PHONE: (800) 370-9431
MAIL ADDRESS:
STREET 1: 30699 RUSSELL RANCH ROAD. SUITE 200
CITY: WESTLAKE VILLAGE
STATE: CALIFORNIA
ZIP: 91362
FILED BY:
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
WASHINGTON, D.C. 20549
SCHEDULE 13D
UNDER THE SECURITIES EXCHANGE ACT OF 1934
(AMENDMENT NO.____)*
Capital Source Healthcare REIT
(Name of Issuer)
Common Stock
(Title of Class of Securities)
(CUSIP Number)
9298 SVL Box, Victorville, CA 92395
(Name, Address and Telephone Number of Person Authorized to Receive Notices
and Communications)
April 16, 2009
(Date of Event Which Requires Filing of this Statement)
If the filing person has previously filed a statement on Schedule 13G to report
the acquisition that is the subject of this Schedule 13D, and is filing this
schedule because of ss.ss.240.13d-1(e), 240.13d-1(f) or 240.13d-1(g), check the
following box. [_]
NOTE: Schedules filed in paper format shall include a signed original and five
copies of the schedule, including all exhibits. See ss.240.13d-7 for other
parties to whom copies are to be sent.
* The remainder of this cover page shall be filled out for a reporting
person's initial filing on this form with respect to the subject class of
securities, and for any subsequent amendment containing information which
would alter disclosures provided in a prior cover page.
The information required on the remainder of this cover page shall not be deemed
to be "filed" for the purpose of Section 18 of the Securities Exchange Act of
1934 ("Act") or otherwise subject to the liabilities of that section of the Act
but shall be subject to all other provisions of the Act (however, see the
Notes).
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
CONTROL NUMBER.
CUSIP No.
1. Names of Reporting Persons.
I.R.S. Identification Nos. of above persons (entities only).
Capital Source Healthcare REIT 262730129
2. Check the Appropriate Box if a Member of a Group (See Instructions)
(a) [_]
(b) [_]
3. SEC Use Only
4. Source of Funds (See Instructions)
PF
5. Check if Disclosure of Legal Proceedings Is Required Pursuant to Items
2(d) or 2(e) [_]
6. Citizenship or Place of Organization
Delaware
7. Sole Voting Power
15,000,000
Number of
Shares Bene- 8. Shared Voting Power
ficially by -0-
Owned by Each
Reporting 9. Sole Dispositive Power
Person With 15,000,000
10. Shared Dispositive Power
15,000,000
11. Aggregate Amount Beneficially Owned by Each Reporting Person
15,000,000
12. Check if the Aggregate Amount in Row (11) Excludes Certain Shares
(See Instructions)
[_]
13. Percent of Class Represented by Amount in Row (11)
100%
14. Type of Reporting Person (See Instructions)
IN
INSTRUCTIONS FOR COVER PAGE
(1) NAMES AND I.R.S. IDENTIFICATION NUMBERS OF REPORTING PERSONS--Furnish the
full legal name of each person for whom the report is filled - i.e., each
person required to sign the schedule itself including each member of a
group. Do not include the name of a person required to be identified in
the report but who is not a reporting person. Reporting persons that are
entities are also requested to furnish their I.R.S. identification
numbers, although disclosure of such numbers is voluntary, not mandatory
(see "SPECIAL INSTRUCTIONS FOR COMPLYING WITH SCHEDULE 13D" below).
(2) If any of the shares beneficially owned by a reporting person are held as
a member of a group and the membership is expressly affirmed, please check
row 2(a). If the reporting person disclaims membership in a group or
describes a relationship with other persons but does not affirm the
existence of a group, please check row 2(b) [unless it is a joint filing
pursuant to Rule 13d-1(k)(1) in which case it may not be necessary to
check row 2(b)].
(3) The 3rd row is for SEC internal use; please leave blank.
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SCHEDULE 13D
ITEM 1. SECURITY AND ISSUER.
This Schedule 13D relates to the common stock of Capital Source Healthcare REIT
a Luxembourg company (the "Issuer"). The address of the
principal executive office of the Issuer is 30699 RUSSELL RANCH ROAD.
SUITE 200 WESTLAKE VILLAGE, CA 91362
JayCee James has controlling interest of Capital Source Healthcare REIT
ITEM 2. IDENTITY AND BACKGROUND.
1 (a) Name: Capital Source Healthcare REIT
(b) 30699 RUSSELL RANCH ROAD. SUITE 200
WESTLAKE VILLAGE, CA 91362
(c) Principal Occupation: REAL ESTATE INVESTMENT TRUSTS
(d) Criminal Convictions: N/A TO REPORTING PERSON
(e) Civil or Administrative Proceedings: N/A TO REPORTING PERSON
ITEM 3. SOURCE AND AMOUNT OF FUNDS OR OTHER CONSIDERATION
The Reporting Person acquired the subject shares of common stock in connection
with the reported SEC Filings of Capital Source Healthcare REIT, The transaction
was consummated on APRIL 13, 2009 and no funds or financing were used in
connection with the transaction.
ITEM 4. PURPOSE OF THE TRANSACTION
The Reporting Person acquired their beneficial ownership in the shares in the
transactions described in Item 3. Except as indicated below, the Reporting
Person have no plans or proposals which relate to, or may result in, any of the
matters listed in items 4 (a)-(j) of schedule 13D, including:
(a) The acquisition by any person of additional securities of the Issuer,
or the disposition of securities of the Issuer, except that
TVSl SA In Liquidation, is actively trying to raise capital to fund
operations of the issuer.
(b) An extraordinary corporate transaction, such as a merger,
reorganization or liquidation involving the Issuer.
(c) A sale or transfer of a material amount of assets of the Issuer.
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(d) Any change in the present board of directors or management of the
Issuer, including plans or proposals to change the number or term of
directors or to fill any existing vacancies on the board.
(e) Any material change in the present capitalization or dividend policy
of the issuer;
(f) Any other material change in the Issuer's business or corporate
structure including but not limited to, if the Issuer is a registered
closed-end investment company, any plans or proposals to make any
changes in its investment policy for which a vote is required by
section 13 of the Investment Company Act of 1940.
(g) Changes in the Issuer's charter, bylaws or instruments corresponding
thereto or other actions which may impede the acquisition of control
of the Issuer by any person;
(h) Causing a class of securities of the Issuer to be delisted from
national securities exchange or to cease to be authorized to be quoted
in an inter-dealer quotation system of a registered national
securities association, provided, however, that following the
acquisition the NASDAQ notified Issuer that it would be removed from
NASD Automated Quotation System, pending a renewal of its application
to be included on that exchange;
(i) A class of equity securities of the Issuer becoming eligible for
termination of registration pursuant to Section 12(g)(4) of the Act;
or
(j) Any action similar to any of those enumerated above.
ITEM 5. INTEREST IN SECURITIES THE ISSUER.
(a) The Reporting Person, is the beneficial owner of 15,000,000 (100.0%)
of the shares of common stock of the Issuer. The Percentage of the
outstanding shares is calculated based upon 15,000,000 shares of
common stock outstanding as of April 13, 2009.
(b) The Reporting Person has the direct power to note and dispose of all
15,000,000 shares of common stock.
(c) Except as otherwise disclosed herein, during the past 60 days the
Reporting Person has not affected any transaction in the common stock
of the Issuer.
(d) The Reporting Persons have the right to receive or the power to direct
the receipt of dividends from, or the proceeds from the sale of the
securities they hold.
(e) The Reporting Persons has not ceased to be the beneficial owners of
more than five percent of the common stock.
ITEM 6. CONTRACTS, ARRANGEMENTS, UNDERSTANDINGS OR RELATIONSHIPS WITH RESPECT
TO SECURITIES OF THE ISSUER
The Reporting Persons are not a party to any contracts, arrangements,
understandings or relationships (legal or otherwise) with any other person
or any person with respect to securities of the Issuer, including but not
limited to transfer or voting of any securities.
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ITEM 7. MATERIAL TO BE FILED AS EXHIBITS
The following shall be filed as exhibits: copies of written agreements
relating to the filing of joint acquisition statements as required by
$240.13d-l(k) and copies of all written agreements, contracts, arrangements,
understandings, plans or proposals relating to: (1) the borrowing of funds to
finance the acquisition as disclosed in Item 3; (2) the acquisition of issuer
control, liquidation, sale of assets, merger, or change in business or corporate
structure or any other matter as disclosed in Item 4; and (3) the transfer or
voting of the securities, finder's fees, joint ventures, options, puts, calls,
guarantees of loans, guarantees against loss or of profit, or the giving or
withholding of any proxy as disclosed in Item 6.
SIGNATURE
After reasonable inquiry and to the best of my knowledge and belief, I
certify that the information set forth in this statement is true, complete and
correct.
Date April 16, 2009
Signature /s/ JayCee James
Name/title JayCee James Majority Holder
The original statement shall be signed by each person on whose behalf the
statement is filed or his authorized representative. If the statement is signed
on behalf of a person by his authorized representative (other than an executive
officer or general partner of the filing person), evidence of the
representative's authority to sign on, behalf of such person shall be filed with
the statement: provided, however, that a power of attorney for this purpose
which is already on file with the Commission may be incorporated by reference.
The name and any title of each person who signs the statement shall be typed or
printed beneath his signature.
ATTENTION: INTENTIONAL MISSTATEMENTS OR OMISSIONS OF FACT CONSTITUTE FEDERAL
CRIMINAL VIOLATIONS (SEE 18 U.S.C. 1001)
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