SEC Form 4 · accession 0001571049-15-008369
InsPro Technologies Corp · ITCC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Edmond Walters
Director
Period of report
Sep 18, 2015
Accepted (ET)
Oct 23, 2015 · 11:27 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001309442
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Convertible Preferred StockF1 | — | Sep 18, 2015 | P | 166,666 | A | Sep 18, 2015 | — | Common | 3,333,320 | 3,333,320 | D |
| Warrants to Purchase Common StockF1 | $0.15 | Sep 18, 2015 | P | 1,666,660 | A | Sep 18, 2015 | Nov 20, 2017 | Common | 1,666,660 | 1,666,660 | D |
Explanation of responses
- F1In a private placement conducted by the Issuer on September 18, 2015, Mr. Edmond Walters purchased 166,666 Units, at $3.00 per Unit, with each Unit consisting of one share of Series B Convertible Preferred Stock (convertible into 20 shares of the Issuer's Common Stock, subject to certain adjustments), and a Warrant to purchase 10 shares of the Issuer's Common Stock. There is no expiration date for the conversion of the Series B Convertible Preferred Stock, and no exercise price to be paid in connection therewith. The expiration date to exercise such Warrants is November 20, 2017, and the exercise price to be paid in connection with each share of such Issuer's Common Stock is $0.15.