SEC Form 4 · accession 0001213900-15-001958
INTERCLOUD SYSTEMS, INC. · ICLD
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Douglas R Shooker
10% Owner
Period of report
Mar 4, 2015
Accepted (ET)
Mar 20, 2015 · 6:14 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001128725
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Oct 19, 2014 | P$0 | 75,000 | — | A | 994,228 | I | See Footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory NoteF2,F1,F3,F4 | $6.36 | Mar 4, 2015 | P | 748,942 | A | — | — | Common Stock | 748,942 | 1,767,024 | I |
Explanation of responses
- F1Represents shares owned by Forward Investments LLC and the Reporting Person. The Reporting Person beneficially owns the shares held by Forward Investments LLC.
- F2Represents shares of common stock issued to Forward Investments LLC in connection with the restructuring of debt extended by Forward Investments LLC to the Issuer, in order to extend the maturity dates thereof, reduce the seniority and reduce the interest rate accruing thereon, as well as shares of common stock issued to Forward Investments LLC in lieu of cash interest.
- F3Immediately exercisable.
- F4Expiration dates range from July 1, 2016, to January 1, 2018.