SEC Form 4 · accession 0001144204-17-001461
INTELLINETICS, INC. · INLX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew L Chretien
Officer — CHIEF EXECUTIVE OFFICER · Director
Period of report
Jan 5, 2017
Accepted (ET)
Jan 9, 2017 · 8:40 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001081745
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common stock | Jan 5, 2017 | C | 496,111 | $0.007 | A | 1,423,477 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF1 | $0.007 | Jan 5, 2017 | C | 500,000 | D | Sep 3, 2014 | Feb 14, 2017 | Common stock | 500,000 | 110,595 | D |
Explanation of responses
- F1The warrant is being exercised at $0.007 per share.