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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 | ||||||||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 15,839 (2) | 01/10/2017 | (3) | Common Stock | 50,685 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 2,821 (2) | 01/10/2017 | (3) | Common Stock | 9,027 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 133,496 | 03/31/2017 | (4) | Common Stock | 427,187 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 679,090 | 08/23/2017 | (5) | Common Stock | 2,173,088 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 74,003 | 08/23/2017 | (5) | Common Stock | 236,810 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 31,414 | 10/09/2017 | (6) | Common Stock | 100,525 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 118,093 | 01/05/2018 | (7) | Common Stock | 377,898 | $ 0.3125 | 0 | I (1) | See Footnote | |||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 9,308 (8) | 08/03/2016 | (9) | Common Stock | 29,786 | $ 0.3125 | 0 | D | ||||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 22,216 (2) | 01/12/2016 | (10) | Common Stock | 71,091 | $ 0.3125 | 0 | D | ||||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 15,721 (2) | 04/11/2016 | (11) | Common Stock | 50,307 | $ 0.3125 | 0 | D | ||||
Convertible Promissory Note | $ 0.3125 | 03/12/2018 | M | $ 8,689 (2) | 07/26/2016 | (12) | Common Stock | 27,805 | $ 0.3125 | 0 | D |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Koretsky Frank 11767 SOUTH DIXIE HIGHWAY, #115 MIAMI, FL 33156 |
X | X |
/s/ Frank Koretsky | 03/14/2018 | |
**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) | Owned by Newcan Investment Partners LLC, an entity wholly owned by the Reporting Person. |
(2) | Represents conversion of remaining unpaid interest that accrued on a convertible promissory note that was converted on May 31, 2017. |
(3) | 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. |
(4) | 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. |
(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 August 22, 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 October 8, 2020. |
(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, 2021. |
(8) | Represents conversion of remaining unpaid interest that accrued on a convertible promissory note held by CLS Co 2016, LLC, an entity of which the Reporting Person is a member, that was converted on May 31, 2017. Since CLS Co 2016, LLC's acquisition of this convertible note, the Reporting Person has taken a controlling position in this entity and shares issued upon conversion were issued in the name of the Reporting Person. |
(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 January 1, 2019. |
(11) | 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. |
(12) | 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. |