SEC Form 4 · accession 0001144204-15-000668
Iveda Solutions, Inc. · IVDA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert Gillen
Director
Period of report
Dec 31, 2014
Accepted (ET)
Jan 5, 2015 · 9:50 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001397183
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Options (Right to buy)F1 | $1.15 | Dec 31, 2014 | A | 50,000 | A | — | Dec 31, 2024 | Common Stock | 50,000 | 50,000 | D |
| Warrants (Right to buy)F2,F3 | $1.00 | Jan 5, 2015 | P | 25,000 | A | Jan 5, 2015 | Jan 5, 2020 | Common Stock | 25,000 | 25,000 | I |
Explanation of responses
- F1The options subject to this grant vested 100% on the date of the grant.
- F2On December 9, 2014, Squirrel-Away, LLC purchased a 9.5% Debenture (the "Debenture") from the Company in the principal amount of $100,000. The Debenture is due and payable on January 5, 2015. Under the terms of the Debenture, the Company is required to issue a warrant for an additional 25,000 shares for each month the Debenture is outstanding after the initial Maturity Date. Pursuant to the terms of the Debenture, Squirrel-Away, LLC received a warrant to purchase 25,000 shares of Common Stock.
- F3The securities are held by Squirrel-Away, LLC. The sole member of Squirrel-Away, LLC is G&G Trust dated 11/3/2004, which is beneficially owned by Robert Gillen and Mary Gillen (as beneficiaries of the trust). Robert Gillen and Mary Gillen are also managers of Squirrel-Away, LLC, and therefore have voting and investment power with respect to the shares of Iveda common stock held by Squirrel-Away, LLC.