SEC Form 5 · accession 0001393905-15-000024
Galaxy Gaming, Inc. · GLXZ
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Norman H DesRosiers
Director
Period of report
Dec 31, 2014
Accepted (ET)
Jan 20, 2015 · 11:33 am EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000013156
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 1, 2014 | A | 100,000 | $0.00 | A | 100,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionF2 | $0.34 | Mar 31, 2014 | A | 8,333 | A | Mar 31, 2014 | Mar 31, 2019 | Common Stock | 8,333 | 8,333 | D |
| OptionF2 | $0.45 | Jun 30, 2014 | A | 25,000 | A | Jun 30, 2014 | Jun 30, 2019 | Common Stock | 25,000 | 33,333 | D |
| OptionF2 | $0.39 | Sep 30, 2014 | A | 25,000 | A | Sep 30, 2014 | Sep 30, 2019 | Common Stock | 25,000 | 58,333 | D |
| OptionF2 | $0.39 | Dec 31, 2014 | A | 25,000 | A | Dec 31, 2014 | Dec 31, 2019 | Common Stock | 25,000 | 83,333 | D |
Explanation of responses
- F1Shares were received in connection with the Reporting Person's appointment to the Issuer's board of directors.
- F2Options were received in connection with the Reporting Person's service on the Issuer's board of directors.