SEC Form 4 · accession 0001102948-17-000003
Celsius Holdings, Inc. · CELH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Carl Desantis
10% Owner
Period of report
Oct 9, 2017
Accepted (ET)
Oct 11, 2017 · 4:08 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001341766
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 C Convertible Preferred StockF3,F2 | $0.52 | Oct 9, 2017 | J | 383 | A | — | Dec 31, 2018 | Common Stock | 736,538 | 2,763 | I |
Explanation of responses
- F1Represents the issuance to CDS Ventures of South Florida, LLC, as the holder of shares of Series C Convertible Preferred Stock, of 383 additional shares of Series C Convertible Preferred Stock pursuant to the applicable preferred dividend that accrues on the stated value of such shares at a rate of 6% per annum.
- F2The holder of Series C Convertible Preferred Stock has the right to convert at any time until the applicable maturity date for such shares.
- F3Carl DeSantis owns a beneficial interest of 100% in CDS Ventures of South Florida, LLC which is the holder of record of the shares of Series C Convertible Preferred Stock listed above.