SEC Form 5 · accession 0001511164-15-000073
Champion Pain Care Corp · CPAI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jack Fishman
Officer — President · Director
Period of report
Dec 31, 2014
Accepted (ET)
Feb 17, 2015 · 2:45 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001469284
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Jun 13, 2014 | J | 7,500,000 | $0.0001 | A | 7,500,000 | D | |
| Common Stock | Jun 19, 2014 | G | 3,750,000 | $0.00 | D | 3,750,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Remarks
1. On June 13, 2014, Champion Care Corp. transferred 7,500,000 shares of the Common Stock of the Issuer to Jack Fishman, who is an Officer and a Director of Champion Care Corp. and accepted the shares for services rendered to Champion Toronto. 2. On June 19, 2014, Jack Fishman transferred 3,750,000 shares of the Common Stock of the Issuer to his spouse, Sheena Sim, as a gift.