SEC Form 4 · accession 0001415889-15-003140
Be Active Holdings, Inc. · JALA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Saverio Pugliese
Officer — VICE PRESIDENT · Director · 10% Owner
Period of report
Feb 18, 2014
Accepted (ET)
Sep 21, 2015 · 7:14 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001514514
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Feb 18, 2014 | P | 4,166,666 | $0.03 | A | 11,006,221 | D | |
| Common Stock | Jan 9, 2015 | J | 16,666,666 | $0.00 | A | 27,672,887 | D | |
| Common Stock | Dec 31, 2014 | P | 5,000,000 | $0.0001 | A | 32,672,887 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series B Convertible Preferred StockF2 | — | Mar 2, 2015 | J | 1 | D | — | — | Common stock | — | 0 | D |
| Series D Convertible Preferred StockF4 | $0.0039 | Mar 4, 2015 | J | 1,000,000 | A | Mar 4, 2015 | — | Common stock | 1,000,000 | 1,000,000 | D |
Explanation of responses
- F1Represents shares issued pursuant to anti-dilution rights of the Reporting Person
- F2The Series B Convertible Preferred Stock was cancelled on March 2. 2015.
- F3Granted by the Issuer for services provided
- F4Series D Convertible Preferred Stock does not expire