SEC Form 5 · accession 0001615774-16-004592
VERTICAL COMPUTER SYSTEMS INC · VCSY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Dec 31, 2015 | J | 1,000,000 | $0.00 | A | 1,083,000 | I | Owned by Parker Shumaker Mills, LLP |
| Common Stock | holding | — | — | — | 250,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant (Right to Buy) | $0.10 | Dec 31, 2015 | J | 1,000,000 | A | Dec 31, 2015 | Dec 31, 2018 | Common Stock | 1,000,000 | 1,000,000 | I |
Remarks
Mr. Mills owns 250,000 shares of common stock of Vertical Computer Systems, Inc. (the "Company" or "Issuer") and 1,083,333 shares of common stock of the Company through Parker Mills, LLP ("Parker Mills") for a total of 1,333,333 shares beneficially owned by Mr. Mills. Mr. Mills is a partner of Parker Mills. On December 31, 2015, Parker Mills loaned $100,000 to the Company, which issued a $100,000 convertible debenture to Parker Mills. In connection with the loan, the Company issued 1,000,000 shares of common stock of the Company and issued a 3-year warrant to purchase an additional 1,000,000 shares of common stock of the Company at $0.10 per share to Parker Mills.