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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 | ||||||||
| Demand Convertible Promissory Note | $ 0.25 | 05/31/2017 | J(2) | $ 618,000 | 05/31/2017 | (4) | Common Stock | 2,472,000 (11) | $ 618,000 | 2,472,000 | I (1) | See Footnote | |||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 50,220 | 01/10/2017 | (5) | Common Stock | 200,800 | $ 0.25 | 0 | I (1) | See Footnote | |||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 417,527 | 01/10/2017 | (5) | Common Stock | 1,670,108 | $ 0.25 | 0 | I (1) | See Footnote | |||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 978,089 | 01/12/2016 | (6) | Common Stock | 3,912,356 | $ 0.25 | 0 | D | ||||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 415,302 | 04/11/2016 | (7) | Common Stock | 1,661,208 | $ 0.25 | 0 | D | ||||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 221,678 | 07/20/2016 | (8) | Common Stock | 886,712 | $ 0.25 | 0 | D | ||||
| Convertible Promissory Note | $ 0.25 (3) | 05/31/2017 | M | $ 159,247 | 08/03/2016 | (9) | Common Stock | 636,988 | $ 0.25 | 0 | I (12) | See Footnote | |||
| Convertible Promissory Note | $ 0.25 (13) | 03/31/2017 | (10) | Common Stock | 480,000 (11) | 480,000 | I (1) | See Footnote | |||||||
| Reporting Owner Name / Address | Relationships | |||
| Director | 10% Owner | Officer | Other | |
| Koretsky Frank 11767 S. DIXIE HIGHWAY, STE 115 MIAMI, FL 33156 |
X | X | ||
| /s/ Frank Koretsky | 06/02/2017 | |
| **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) | Owned by Newcan Investment Partners LLC, an entity wholly owned by the Reporting Person. |
| (2) | This Note bears interest at the rate of 10% per annum. At the election of the Reporting Person, all principal and accrued interest under the Note may be converted into the Issuer's common stock. For each $0.25 converted, the Reporting Person will receive one share of common stock. The balance of the terms of this Note have not yet been determined. |
| (3) | Convertible Notes were amended to reduce the conversion price to $0.25 and delete the requirement to issue warrants upon conversion. Shares were issued upon conversion for all accrued interest. |
| (4) | Not yet determined. |
| (5) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on January 2, 2020. |
| (6) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on January 1, 2019. |
| (7) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on April 1, 2019. |
| (8) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on July 1, 2019. |
| (9) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on August 1, 2018. |
| (10) | The Note is convertible, at the election of the Reporting Person, at any time prior to payment or prepayment in full and matures on April 1, 2020. |
| (11) | Excludes shares issuable at the election of the Reporting Person upon conversion of accrued interest (both past and future) into shares of common stock. |
| (12) | Owned by CLS Co 2016, LLC, an entity of which the Reporting Person is a member. Since CLS Co 2016, LLC's acquisition of this convertible note, the Reporting Person has taken a controlling position in this entity. Shares issued upon conversion were issued in the name of the Reporting Person. |
| (13) | Convertible Note was amended to delete the requirement to issue warrants upon conversion. |