SEC Form 5 · accession 0001511164-15-000131
Champion Pain Care Corp · CPAI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Allan Gold
10% Owner
Period of report
Dec 31, 2014
Accepted (ET)
Feb 25, 2015 · 2:58 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 19, 2014 | G | 6,750,000 | $0.00 | A | 6,750,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Remarks
On June 19, 2014, Allan Gold received 6,750,000 shares of the Common Stock of the Issuer from Jason Gold as a gift.