SEC Form 4 · accession 0001144204-16-127080
CORETEC GROUP INC. · CRTG
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Victor F Keen
Officer — Chief Executive Officer · Director · 10% Owner
Period of report
Sep 30, 2016
Accepted (ET)
Oct 5, 2016 · 5:28 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001375195
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 B Convertible Preferred StockF2,F4,F1,F3 | — | Sep 30, 2016 | A | 111,880 | A | Sep 30, 2016 | — | Common Stock | 214,138,320 | 1,345,968 | D |
| Series B Convertible Preferred StockF5,F1,F3 | — | Sep 30, 2016 | A | 152,386 | A | Sep 30, 2016 | — | Common Stock | 291,666,804 | 1,457,848 | D |
Explanation of responses
- F1Each share of Series B Convertible Preferred Stock is convertible into 1,914 shares of common stock.
- F2Pursuant to the issuance of Series B Convertible Preferred Stock by Issuer to Cartlon James North Dakota LTD of which the Reporting Person is a member. The number of shares represented in this column reflects the pro rata amount beneficially owned by the Reporting Person.
- F3None
- F4The price of the derivative security was not determined for this transaction as the issuance reported was made in connection with a share exchange between the Issuer and Reporting Person on September 30, 2016.
- F5The price of the derivative security was not determined for this transaction as the issuance reported was made in lieu of a cash payment equal to $87,500.