SEC Form 5 · accession 0001433045-16-000001
COPsync, Inc. · COYN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Russell Dean Chaney
Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 28, 2016 · 5:14 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001383154
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | Nov 18, 2015 | P | 8,500 | $3.49 | A | 923,740 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF3 | $3.125 | Nov 18, 2015 | P | 8,500 | A | Nov 18, 2015 | Nov 18, 2020 | Common Stock | 8,500 | 13,500 | D |
Explanation of responses
- F1Purchased in Company's public offering.
- F2Includes 759,954 shares held by Mr. Chaney directly, 144,366 shares held jointly with his spouse, and 19,420 shares held by RSIV, LLC, which is controlled and owned equally by Mr. Chaney and Mr. Rapp.
- F3Includes 3,000 shares purchasable by Mr. Chaney's spouse pursuant to an option agreement and 2,000 issuable upon conversion of our Series A preferred stock held by RSIV, LLC.