SEC Form 4 · accession 0001493152-19-003270
INTELLINETICS, INC. · INLX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Matthew L Chretien
Officer — CHIEF STRATEGY OFFICER · Director
Period of report
Mar 11, 2019
Accepted (ET)
Mar 13, 2019 · 5:49 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001081745
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock OptionF2,F1 | $0.90 | Jan 1, 2016 | D | 100,000 | D | — | Dec 31, 2025 | Common Stock | 100,000 | 10,595 | D |
| Incentive Stock OptionF3,F1 | $0.13 | Mar 11, 2019 | A | 100,000 | A | — | Mar 10, 2029 | Common Stock | 100,000 | 110,595 | D |
Explanation of responses
- F1Options vested annually over a 4-year period, ending January 1, 2019 (newly issued option is fully vested).
- F2Options were cancelled and exchanged for newly issued incentive stock options at a price of $0.13.
- F3Options were issued under the 2015 Intellinetics Inc. Equity Incentive Plan in exchange for an equal number of cancelled options.