SEC Form 4 · accession 0001171843-18-001554
Crystal Rock Holdings, Inc. · CRVP
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ross S Rapaport
Director · 10% Owner
Period of report
Feb 23, 2018
Accepted (ET)
Feb 28, 2018 · 4:17 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001123316
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.001F1 | Feb 23, 2018 | G | 4,005,472 | $0.00 | D | 23,846 | I | Trustee |
| Common Stock, par value $0.001 | holding | — | — | — | 10,040 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Consists of shares held by the Reporting Person as Trustee of U/T/A dated 12/16/91 F/B/O Joan Baker et al., Peter K. Baker Life Insurance Trust, and John B. Baker Life Insurance Trust. The Reporting Person disclaims beneficial ownership of these shares, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such shares for purposes of Section 16 or for any other purpose.