SEC Form 4 · accession 0001140361-16-060433
BLONDER TONGUE LABORATORIES INC · BDR
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert J Palle Jr.
Officer — President and CEO · Director · 10% Owner
Period of report
Dec 23, 2015
Accepted (ET)
Apr 6, 2016 · 5:04 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001000683
Table I — non-derivative securities
No Table I lines on this filing.
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible LoanF1,F2 | $0.54 | Dec 23, 2015 | J | — | A | Dec 23, 2015 | Mar 28, 2019 | Common Stock | — | 185,185 | D |
| Convertible LoanF1,F2 | $0.54 | Feb 11, 2016 | J | — | A | Feb 11, 2016 | Mar 28, 2019 | Common Stock | — | 370,370 | D |
| Convertible LoanF1,F2 | $0.54 | Feb 23, 2016 | J | — | A | Feb 23, 2016 | Mar 28, 2019 | Common Stock | — | 462,962 | D |
| Convertible LoanF1,F2 | $0.54 | Feb 25, 2016 | J | — | A | Feb 25, 2016 | Mar 28, 2019 | Common Stock | — | 555,554 | D |
| Convertible LoanF1,F2 | $0.54 | Mar 31, 2016 | J | — | A | Mar 31, 2016 | Mar 28, 2019 | Common Stock | — | 648,146 | D |
Explanation of responses
- F1The reporting person and the company are parties to an Amended and Restated Senior Subordinated Convertible Loan and Security Agreement dated as of March 28, 2016 (the "Subordinated Loan Agreement"), pursuant to which the lenders identified therein have agreed to provide the company with a delayed draw term loan facility of up to $750,000. The lenders, including the reporting person, have the option of converting the principal balance of loans made under the Subordinated Loan Agreement into shares of the company's common stock at a conversion price of $0.54 per share, subject to adjustment under certain circumstances. On March 31, 2016, the reporting person provided a loan of $100,000 to the company under the Subordinated Loan Agreement.
- F2The rights to convert the loan under the Subordinated Loan Agreement are jointly held by the reporting person and his spouse.