SEC Form 4 · accession 0001140361-15-019192

CapForce Inc. · CFOR

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

May 8, 2015

Accepted (ET)

May 12, 2015 · 6:51 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001293818

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F4	May 8, 2015	P	300,833	$6.00	A	330,716	I	See footnote
Common Stock^F1,F4	May 8, 2015	C	610,017	—	A	940,733	I	See footnote
Common Stock^F2,F4	May 8, 2015	C	209,020	—	A	1,149,753	I	See footnote
Common Stock^F3,F4	May 8, 2015	C	260,043	—	A	1,409,796	I	See footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Series A Redeemable Convertible Preferred Stock^F4,F1	—	May 8, 2015	C	610,017	D	—	—	Common Stock	610,017	0	I
2014 Convertible Notes^F4,F2	—	May 8, 2015	C	209,020	D	—	—	Common Stock	209,020	0	I
2015 Convertible Notes^F4,F3	—	May 8, 2015	C	260,043	D	—	—	Common Stock	260,043	0	I
Warrants^F4	$6.60	May 8, 2015	P	300,833	A	May 8, 2015	May 8, 2020	Common Stock	300,833	300,833	I

F1Series A Redeemable Convertible Preferred Stock automatically converted into common stock on a 1-to-1 basis upon the consummation of the Company's initial public offering.
F2The 2014 Convertible Notes automatically converted into shares of Series A Preferred Stock upon the consummation of the Company's initial public offering at a conversion rate of one share of Series A Preferred Stock for every $1.00 of principal converted. Each share of Series A Preferred Stock automatically converted into one share of common stock upon the consummation of the Company's initial public offering.
F3The 2015 Convertible Notes converted into Series A Preferred Stock upon the consummation of the Company's initial public offering at a conversion rate of 1.25 shares of Series A Preferred Stock for each $1.00 of principal converted. Each share of Series A Preferred stock automatically converted into one share of common stock upon the consummation of the Company's initial public offering.
F4The securities are directly held by Harris & Harris Group, Inc. Dr. Ushio is Chief Strategy Officer and Managing Director of Harris & Harris Group, Inc., and may be deemed to have shared voting power over the shares owned by Harris & Harris Group, Inc. Dr. Ushio disclaims beneficial ownership of all shares held by Harris & Harris Group, Inc., except to the extent of her actual pecuniary interest therein.