SEC Form 5 · accession 0001437749-15-022096
VERUS INTERNATIONAL, INC. · VRUS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Keith A White
Director
Period of report
Oct 31, 2015
Accepted (ET)
Dec 11, 2015 · 3:45 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001430523
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | holding | — | — | — | 200,000 | I | See footnote |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Preferred StockF2,F3 | — | Aug 6, 2015 | D | 15,000 | D | Aug 19, 2014 | — | Common Stock | 1,500,000 | 0 | D |
| Series C Preferred StockF4,F1,F3 | $0.05 | Aug 6, 2015 | A | 15,000 | A | Aug 6, 2015 | — | Common Stock | 1,500,000 | 15,000 | I |
Explanation of responses
- F1Keith White is the owner of Marketplace Home Mortgage LLC, the owner of the referenced security.
- F2Each share of Series B preferred stock converts into 100 shares common stock. The Reporting Person paid $75,000 for these shares.
- F3Not applicable.
- F4The Reporting Person exchanged his 15,000 shares of series B preferred stock (for which he paid $75,000) for the 15,000 shares of series C preferred stock