SEC Form 4 · accession 0001179110-16-032830
CREATIVE REALITIES, INC. · CREX
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Eric J Bertrand
Director
Period of report
May 3, 2016
Accepted (ET)
Dec 12, 2016 · 5:03 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001356093
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Sep 8, 2016 | P | 19,000 | $0.15 | A | 19,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Secured Convertible Promissory NoteF1,F2 | — | May 3, 2016 | P | 2,110,371 | A | May 3, 2016 | Oct 15, 2017 | Common Stock | 2,110,371 | 2,110,371 | I |
| Warrants to purchase common stockF1,F2 | $0.28 | May 3, 2016 | P | 892,857 | A | May 3, 2016 | May 3, 2021 | Common Stock | 892,857 | 892,857 | I |
Explanation of responses
- F1Purchase involved a Secured Convertible Promissory Note for $500,000, which is convertible into approximately 2,110,371 shares of Common Stock; and a Warrant to purchase 892,857 shares of Common Stock. The Warrant contains provisions blocking exercise if such exercise would result in the purchaser holding more than 4.99% of the Issuer's shares outstanding.
- F2The Reporting Person is a principal of Lincoln Road Media Partners LLC and has voting and investment power for this entity.