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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN 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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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
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. | SEC 1474 (9-02) |
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 Underlying Securities (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 of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Warrants (right to buy) | $ 3.50 | 11/21/2019 | J(1) | 400,000 | 11/04/2017 | 05/04/2027 | Common Stock | 400,000 | (1) | 0 | I | By Larry S. Spitcaufsky Family Trust UTD 1-19-88 |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
SPITCAUFSKY LARRY 16205 VIA DEL ALBA, PO BOX 891 RANCHO SANTA FE, CA 92067 |
Former 10% Owner |
/s/ Larry Spitcaufsky | 11/21/2019 | |
**Signature of Reporting Person | Date |
* | 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). |
(1) | Pursuant to a Securities Exchange Agreement, dated October 31, 2019, the Larry Spitcausfky Trust UTD 1-19-88 agreed to transfer warrants to purchase 400,000 shares of common stock of the Issuer at $3.50 per share along with $2,000,000 of Issuer debentures in exchange for $2,060,000 of debentures issued by a private third party. The transfer was completed on November 21, 2019. No cash consideration was paid for the transfer of the debentures or warrants. |