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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, Section 17(a) of the Public Utility Holding Company Act of 1935 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 | ||||||||
Common Stock Warrant (Right to Buy) | $ 2.25 | 01/03/2012 | 10/31/2014 | Common Stock | 334 (3) | 334 | I | By Global Venture Investments LLC (3) | |||||||
Common Stock Warrant (Right to Buy) | $ 5.25 | 03/22/2013 | P | 19,048 | 03/22/2013 | 03/22/2017 | Common Stock | 19,048 (4) | (4) | 19,382 | I | By Global Venture Investments LLC (3) | |||
Non-Qualified Stock Option (Right to Buy) | $ 0.51 | 12/18/2012 | 06/18/2022 | Common Stock | 348,267 (5) | 348,267 | D | ||||||||
Incentive Stock Option (Right to Buy) | $ 0.51 | 12/18/2012 | 06/18/2022 | Common Stock | 42,533 (5) | 42,533 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Ingriselli Frank C 250 EAST HARTSDALE AVE HARTSDALE, NY 10530 |
X | CEO and President |
/s/ Clark Moore, Attorney in Fact | 08/12/2013 | |
**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) | Common stock of Issuer granted to Reporting Person on August 9, 2013. Grant of restricted stock subject to forfeiture. 40% vests on 6-month anniversary of grant date; 15% vests on the 18-month anniversary of grant date; 15% vests on the 24-month anniversary of grant date; 15% vests on the 30-month anniversary of grant date and the balance 15% vests on the 36-month anniversary of grant date, for so long as recipient remains an employee of, or consultant to, the Company. |
(2) | Post-Split common stock of Issuer owned by Global Venture Investments, LLC, an entity owned and controlled by Reporting Person. |
(3) | Post-split common stock warrants of Issuer owned by Global Venture Investments, LLC, an entity owned and controlled by Reporting Person. |
(4) | Reporting Person acquired common stock warrants pursuant to a Promissory Note and Bridge Financing. |
(5) | Post-split pursuant to April 23, 2013 1:3 reverse split of common stock. |
(6) | Includes post split numbers for restricted stock grant of 116,667 shares (formerly 350,000 shares), an option exercise and issuance of 40,123 shares and 94,345 shares remaining from Founders share grant. |