SEC Form 4 · accession 0001062993-17-001864
COOL TECHNOLOGIES, INC. · WARM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
KHIC LLC
10% Owner
Period of report
Dec 23, 2016
Accepted (ET)
Apr 13, 2017 · 3:03 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001399352
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Series A Preferred StockF1 | Mar 9, 2016 | J | 3 | $0.00 | A | 3 | D | |
| Common Stock, $0.001 par value | Dec 23, 2016 | P | 650,000 | $0.10 | A | 650,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Call Right to Purchase Common Stock | $0.05 | Dec 8, 2016 | P | 4,000,000 | A | Dec 8, 2016 | May 31, 2017 | Common Stock, $0.001 | 4,000,000 | 18,994,914 | D |
| Warrant to Purchase Common StockF2 | $0.06 | Dec 8, 2016 | P | 4,000,000 | A | Dec 8, 2016 | May 31, 2022 | Common Stock, $0.001 | 4,000,000 | 22,994,914 | D |
| Warrant to Purchase Common Stock | $0.12 | Dec 23, 2016 | P | 650,000 | A | Dec 23, 2016 | Dec 23, 2021 | Common Stock, $0.001 | 650,000 | 23,644,914 | D |
| Warrant to Purchase Common Stock | $0.15 | Dec 23, 2016 | P | 650,000 | A | Dec 23, 2016 | Dec 23, 2021 | Common Stock, $0.001 | 650,000 | 24,294,914 | D |
Explanation of responses
- F1Shares were assigned to Reporting Person. Each share of Series A Preferred represents 50,000 shares of Common Stock (and has voting rights to 50,000 shares of Common Stock).
- F2Issuable only upon exercise by the Reporting Person of the Call Right to Purchase Common Stock. If such Call Right is exercised, the warrant expiration date will be five (5) years from the date of exercise of the Call Right.