SEC Form 5 · accession 0001554795-16-000939
AIRWARE LABS CORP. · AIRW
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Daniel E Cohen M.D.
Officer — President · Director
Period of report
Sep 30, 2016
Accepted (ET)
Nov 15, 2016 · 12:21 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001500123
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Sep 27, 2016 | A | 434,000 | $0.078 | A | 434,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| OptionF2 | $0.25 | holding | — | — | — | Aug 17, 2016 | Aug 17, 2025 | Common Stock | 166,667 | 166,667 | D |
| OptionF2 | $0.25 | holding | — | — | — | Aug 17, 2017 | Aug 17, 2025 | Common Stock | 166,666 | 333,333 | D |
| OptionF2 | $0.25 | holding | — | — | — | Aug 17, 2018 | Aug 17, 2025 | Common Stock | 166,667 | 500,000 | D |
Explanation of responses
- F1Dr. Daniel Cohen acquired 434,000 shares of common stock at a cost basis of $0.078 shares directly from the Issuer pursuant to a Debt Conversion Agreement dated September 26, 2016.
- F2On August 17, 2015, Dr. Daniel E. Cohen was appointed as President and director of Airware Labs Corp. Additionally, Dr. Cohen was issued a total of 500,000 options that vest over the next three years and are exercisable at the price of $0.25 per share.