SEC Form 5/A · accession 0001524735-17-000003
COPsync, Inc. · COYN
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 5/A). It replaces an earlier filing for the same period.
Reporting owner
Joseph Rosario Alosa Sr.
Director
Period of report
Dec 31, 2015
Accepted (ET)
Feb 14, 2017 · 8:50 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 | holding | — | — | — | 50,000 | D |
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 StockF5,F2,F3,F4 | — | holding | — | — | — | — | — | Common Stock | 5,233 | 5,233 | D |
Explanation of responses
- F1The beneficial ownership report on Form 5 that was filed with the SEC on January 28, 2016, erroneously attributed 86,000 shares to Mr. Alosa that were actually acquired by his son, Joseph Alosa, Jr. Therefore, the correct amount of securities beneficially owned by Mr. Alosa at the end of December 31, 2015 was actually 50,000 shares of common stock.
- F2At the time the original beneficial ownership report was filed on Form 5, Mr. Alosa had the right to purchase 3,233 shares under an option agreement and his spouse had the right to purchase 2,000 shares of common stock upon the exercise of a warrant. These stock options and warrants have varying exercise prices.
- F3At the time the original beneficial ownership report was filed on Form 5, Mr. Alosa had the right to purchase 3,233 shares under an option agreement and his spouse had the right to purchase 2,000 shares of common stock upon the exercise of a warrant. These stock options and warrants have varying exercise dates.
- F4At the time the original beneficial ownership report was filed on Form 5, Mr. Alosa had the right to purchase 3,233 shares under an option agreement and his spouse had the right to purchase 2,000 shares of common stock upon the exercise of a warrant. These stock options and warrants have varying expiration dates.
- F5At December 31, 2015, Mr. Alosa had 5,233 vested option shares, inclusive of 2,000 shares issuable upon the exercise of a warrant held by Mr. Alosa's spouse.