SEC Form 4 · accession 0001571049-15-010359
InsPro Technologies Corp · ITCC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Donald R Caldwell
Officer — Principal Executive Officer · Director
Period of report
Dec 18, 2015
Accepted (ET)
Dec 28, 2015 · 3:18 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001309442
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock, par value $0.001 per share | Dec 18, 2015 | P | 397,086 | $0.05 | D | 511,096 | D | |
| Common Stock, par value $0.001 per share | holding | — | — | — | 114,010 | D | ||
| Common Stock, par value $0.001 per shareF1,F2 | holding | — | — | — | 85,688,674 | I | See Footnote |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1Includes 10,298,080 shares underlying warrants to purchase Common Stock. Includes 25,000,000 shares underlying 1,250,000 shares of Series A Convertible Preferred Stock, which are convertible, at the sole option of the holder, into 20 shares of Common Stock. Includes 37,743,720 shares of Common Stock underlying 1,887,186 shares of Series B Convertible Preferred Stock, which are convertible, at the sole option of the holder, into 20 shares of Common Stock. Also includes 1,200,000 shares underlying warrants to purchase 60,000 shares of Series B Convertible Preferred Stock, which are convertible, at the sole option of the holder, into 20 shares of Common Stock.
- F2Represents securities owned by The Co-Investment Fund II, L.P., the designee of Cross Atlantic Capital Partners, Inc., of which Donald R. Caldwell is managing partner. Mr. Caldwell is also a shareholder, director and officer of Co-Invest II Capital Partners, Inc., which is the general partner of Co-Invest Management II, L.P., which is the general partner of The Co-Investment Fund II, L.P. Mr. Caldwell disclaims beneficial ownership of these securities, except to the extent of his pecuniary interest therein, and the inclusion of these shares in the report shall not be deemed an admission of beneficial ownership of all the reported shares for purposes of Section 16 for any other purpose.