SEC Form 5 · accession 0001588923-16-000001
MoneyOnMobile, Inc. · MOMT
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Scott S Arey
Officer — Chief Financial Officer
Period of report
Mar 31, 2016
Accepted (ET)
Jul 12, 2016 · 4:46 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001414628
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF2 | holding | — | — | — | 33,334 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Incentive Stock Option (Right to Buy)F1 | $0.50 | Dec 31, 2015 | A | 500,000 | A | Dec 31, 2015 | Dec 31, 2025 | Common | 500,000 | 500,000 | D |
| Common Stock Warrant (Right to Buy) | $2.00 | holding | — | — | — | Nov 29, 2013 | Nov 29, 2018 | Common | 25,000 | 25,000 | D |
| Incentive Stock Option (Right to Buy) | $1.35 | holding | — | — | — | Oct 3, 2013 | Oct 3, 2023 | Common | 400,000 | 400,000 | D |
Explanation of responses
- F1Incentive Stock Option granted to Reporting Person pursuant to Issuer's 2011 Equity Incentive Plan with vesting as follows: Options are fully vested as of 12/31/15, subject to Lockup restrictions where 25% of the shares outstanding will be released upon the 12 month anniversary of Grant Date.
- F2Reporting Person's holdings include 33,334 shares issued pursuant to the $1M 2013 PIPE.