SEC Form 4 · accession 0001441557-16-000070
PSM HOLDINGS INC · PSMH
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jim Miller
Director
Period of report
Apr 6, 2016
Accepted (ET)
Apr 8, 2016 · 7:03 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001362180
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | holding | — | — | — | 1,000,000 | I | Family Trust |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF2,F1 | $0.04 | Apr 6, 2016 | J | 50,000 | A | Feb 13, 2014 | Feb 13, 2019 | Common Stock | 50,000 | 50,000 | D |
| WarrantsF3,F1 | $0.01 | Apr 6, 2016 | J | 50,000 | A | Feb 8, 2016 | Feb 8, 2021 | Common Stock | 50,000 | 50,000 | D |
Explanation of responses
- F1On April 6, 2016, the Company issued 862.5 Series E Preferred Stock with a conversion price of $0.01 which triggered an adjustment in the conversion price of the warrants pursuant to the Certificate of Designation.
- F2Received warrants pursuant to the Bridge Loan Agreement dated 2/10/14
- F3For each $1.00 loaned to the Borrower, the Lender shall receive FOUR-TENTHS (0.4) of one warrant to purchase shares of common stock. An aggregate of $125,000 was paid by Mr. Miller.