SEC Form 4 · accession 0001511164-15-000084

Champion Pain Care Corp · CPAI

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Champion Care Corp.

Other

Period of report

Oct 18, 2013

Accepted (ET)

Feb 17, 2015 · 3:53 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
COMMON STOCK	Jun 13, 2014	J	7,500,000	$0.0001	D	24,000,000	D
COMMON STOCK	Jun 13, 2014	J	7,500,000	$0.0001	D	16,500,000	D
COMMON STOCK	Jun 13, 2014	J	7,500,000	$0.0001	D	9,000,000	D
COMMON STOCK	Jun 13, 2014	J	7,500,000	$0.0001	D	1,500,000	D
COMMON STOCK	Nov 24, 2014	J	1,500,000	$0.10	A	3,000,000	D
COMMON STOCK	Nov 28, 2014	J	985,000	$0.214	D	2,015,000	D
COMMON STOCK	Nov 28, 2014	J	1,500,000	$0.0001	D	515,000	D

Table II — derivative securities

No Table II lines on this filing.

Remarks

1. Champion Care Corp. transferred 7,500,000 Common Shares to Terrance Owen for services rendered to Champion Care Corp. 2. Champion Care Corp. transferred 7,500,000 Common Shares to Jack Fishman for services rendered to Champion Care Corp. 3. Champion Care Corp. transferred 7,500,000 Common Shares to Emil Schiller for services rendered to Champion Care Corp. 4. Champion Care Corp. transferred 7,500,000 Common Shares to Jason Gold for services rendered to Champion Care Corp. 5. Champion Care Corp. received 1,500,000 Common Shares of the Issuer from the Issuer for services rendered to the Issuer. 6. Champion Care Corp. transferred 985,000 Common Shares of the Issuer to certain creditors of Champion Care Corp. 7. Champion Care Corp. transferred 1,500,000 Common Shares of the Issuer to Jason Gold for services rendered to Champion Care Corp.