SEC Form 5 · accession 0001477932-15-006354
Car Monkeys Group · CKMY
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Mariusz Girt
Officer — CEO · Director
Period of report
Jun 30, 2015
Accepted (ET)
Oct 13, 2015 · 5:01 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001496139
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F5 | Jun 13, 2012 | A | 576,160 | $0.36 | A | 133,947 | D | |
| Common StockF2,F5 | Jul 23, 2012 | J | 6,352,775 | $0.00 | A | 133,947 | D | |
| Common StockF3,F5 | Jul 23, 2012 | A | 2,000,000 | $0.0016 | A | 133,947 | D | |
| Common StockF4,F5 | Sep 3, 2014 | G | 312,500 | $0.15 | D | 133,947 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Preferred StockF1,F6,F7 | $0.00 | Jun 13, 2012 | A | 400,000 | A | Jun 13, 2012 | — | Common | 400,000 | 400,000 | D |
Explanation of responses
- F1Issued pursuant to Technology License Agreement and reorganization valued at $353,194 divided by number of common and preferred stock issued. Subject to 20 to 1 reverse split January 16, 2015.
- F2Issued pursuant to stock dividend of five new shares for each outstanding shares. Subject to 20 to 1 reverse split January 16, 2015.
- F3Issued in consideration of $3,334.00. Subject to 20 to 1 reverse split January 16.
- F4Gift valued at market price.
- F5As of September 13, 2015.
- F6No price.
- F7No expiration date.