SEC Form 5 · accession 0001524735-16-000002
COPsync, Inc. · COYN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
A later amendment supersedes this filing — read the amendment. The figures below are kept as originally reported (version chain, not an overwrite).
Reporting owner
Joseph Rosario Alosa Sr.
Director
Period of report
Dec 31, 2015
Accepted (ET)
Jan 28, 2016 · 6:29 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 StockF1 | Nov 18, 2015 | P | 86,000 | $3.49 | A | 136,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF2 | $3.125 | Nov 18, 2015 | P | 86,000 | A | Nov 18, 2015 | Nov 18, 2020 | Common Stock | 86,000 | 91,233 | D |
Explanation of responses
- F1Includes 126,000 shares held by Mr. Alosa directly and 10,000 shares held jointly with his spouse.
- F2Includes 3,233 shares purchasable by Mr. Alosa within 60 days under an option agreement and 2,000 shares issuable upon exercise of a warrant held by Mr. Alosa's spouse.