SEC Form 5 · accession 0001511164-16-000739
Champion Pain Care Corp · CPAI
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mark Conner
Officer — COO · Director
Period of report
Dec 31, 2015
Accepted (ET)
Apr 6, 2016 · 3:18 pm EDT
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 StockF1 | Jun 19, 2015 | J | 10,000,000 | $0.005 | A | 10,000,000 | D |
Table II — derivative securities
No Table II lines on this filing.
Explanation of responses
- F1On June 19, 2015, the Issuer provided 10,000,000 shares of the Common Stock of the Issuer to Mark H. Conner who is an Officer and a Director of the Issuer and accepted the shares as partial compensation for acting as an Officer of the Issuer according to the terms of the Executive Employment Agreement entered into by Mr. Conner and the Issuer on June 12, 2015.