SEC Form 4 · accession 0001140361-16-053444
Southern Concepts Restaurant Group, Inc. · RIBS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jay W Roth
Other
Period of report
Feb 15, 2016
Accepted (ET)
Feb 16, 2016 · 6:03 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001445918
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Feb 15, 2016 | G | 250,000 | — | D | 1,932,427 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF2 | — | Feb 15, 2016 | J | 200,000 | D | — | — | Common Stock | 200,000 | 0 | D |
| Stock OptionsF3 | — | Feb 15, 2016 | J | 729,707 | D | — | — | Common Stock | 729,707 | 0 | D |
| Warrants | $0.10 | Feb 15, 2016 | G | 5,000,000 | D | Dec 31, 2015 | Dec 31, 2019 | Common Stock | 5,000,000 | 0 | D |
Explanation of responses
- F1Mr. Roth gifted common shares on 2/15/16.
- F2Represents the forfeiture of warrants to the reporting person to purchase 200,000 common shares of Company common stock exercisable at $1 per share. Mr. Roth forfeited these warrants on 2/15/2016.
- F3Represents the forfeiture of options to purchase 729,707 common shares of Company stock exercisable at $0.0685 per share. Mr. Roth forfeited these options on 2/15/16.