SEC Form 5 · accession 0001524735-17-000001
COPsync, Inc. · COYN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Joseph Rosario Alosa Sr.
Director
Period of report
Dec 31, 2016
Accepted (ET)
Feb 14, 2017 · 8:00 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001383154
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Option to Purchase Common StockF1,F3,F2 | $1.80 | May 23, 2016 | A | 8,800 | A | Jan 4, 2017 | Jan 3, 2026 | Common Stock | 8,800 | 5,158 | D |
Explanation of responses
- F1Date of Board approval.
- F2The stockholders of COPsync, Inc. (the "Company") approved an amendment to the Company's 2009 Long-Term Incentive Plan (the "Plan) which, in part, increased the number of automatic stock option grants issued to outside Board members on the first business day of each year from 1,200 shares to 10,000 shares. This amendment was made retroactive to January 1, 2016. Mr. Alosa was originally issued 1,200 options on January 4, 2016. This additional grant for 8,800 options reconciles that issuance with the above-mentioned stockholder approved amendment.
- F3Includes 3,158 shares purchasable by Mr. Alosa on 12-31-16 and 2,000 shares issuable upon the exercise of a warrant held by Mr. Alosa's spouse.