SEC Form 4 · accession 0001306734-16-000003
CONCIERGE TECHNOLOGIES INC · CNCG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Nicholas Daniel Gerber
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Nov 25, 2016
Accepted (ET)
Nov 29, 2016 · 4:43 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001005101
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 promissory note (right to buy)F2,F1 | $0.13 | Nov 25, 2016 | P | 2,124,983 | A | Nov 25, 2016 | May 21, 2016 | Common Stock | 2,124,983 | 10,072,416 | I |
Explanation of responses
- F1On May 25, 2016 the Company entered into a convertible promissory note with Wainwright Holdings, Inc., an entity that is affiliated with the Registrant, in the principal amount of $250,000. The note bears interest at four percent (4%) per annum and increases to eight percent (8%) in the event of default by the Company. The note may be prepaid at any time in whole or in part by the Company and is convertible into common stock of the Company at the election of Wainwright Holdings, Inc. on November 25, 2016, at a conversion price of $0.13 per share. The conversion price is subject to adjustment for mergers, consolidations, share exchanges, recapitalizations or similar events and matures on May 25, 2021.
- F2The Registrant indirectly owns the cumulative amount of the derivative securities through Registrant's trust and as an affiliate of Wainwright Holdings, Inc.