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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 | ||||||||
Series A Convertible Preferred Stock | $ 3 | 03/06/2018 | C | 720,135 | 12/17/2014 | (4) | Common Stock | 163,183 | $ 0 | 0 | D (3) | ||||
Series B Convertible Preferred Stock | $ 8.4 | 03/06/2018 | C | 16,176.47 | 04/30/2015 | (4) | Common Stock | 269,608 | $ 0 | 0 | D (3) | ||||
Series F Convertible Preferred Stock | $ 27.5 | 03/06/2018 | J(1) | 3,000 | 09/20/2017 | (4) | Common Stock | 300,000 | (1) | 0 | I | See footnotes (2) (3) | |||
Warrants | $ 30 | 03/06/2018 | J(1) | 150,000 | 09/20/2017 | 09/20/2019 | Common Stock | 150,000 | (1) | 0 | I | See footnotes (2) (3) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Honig Barry C 595 S FEDERAL HIGHWAY SUITE 600 BOCA RATON, FL 33432 |
X |
/s/ Barry Honig | 03/08/2018 | |
**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) | On March 6, 2018, the Reporting Person exchanged the Series F Convertible Preferred Stock and Warrants for shares of Common Stock as disclosed in the Issuer's Form 8-K filed with the Securities and Exchange Commission on March 7, 2018. |
(2) | The securities reported on this line are held by GRQ Consultants, Inc. 401K (of which Barry Honig ("Mr. Honig") is Trustee), GRQ Consultants, Inc. (of which Mr. Honig is President), GRQ Consultants, Inc. Roth 401K FBO Barry Honig (of which Mr. Honig is Trustee), GRQ Consultants, Inc. Roth 401K FBO Renee Honig (of which Mr. Honig's wife, Renee Honig, is Trustee) and/or the Barry & Renee Honig Charitable Foundation, Inc. (of which Mr. Honig is President). |
(3) | The Reporting Person disclaims beneficial ownership of the securities reported herein for purposes of Section 16 of the Securities and Exchange Act of 1934, as amended, except as to such extent of the Reporting Person's pecuniary interest therein. |
(4) | Such convertible preferred stocks have no expiration date. |