SEC Form 4 · accession 0001493152-15-002522

Mama's Creations, Inc. · MAMA

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director

Period of report

Jun 12, 2015

Accepted (ET)

Jun 16, 2015 · 6:37 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001520358

Table I — non-derivative securities

No Table I lines on this filing.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Convertible Debenture^F1	$1.50	May 15, 2015	J	1	D	May 15, 2015	Jul 15, 2016	Common Stock	33,334	0	I
Series A Convertible Preferred Stock^F1,F4	$1.25	Jun 12, 2015	J	500	A	Jun 12, 2015	—	Common Stock	40,000	500	I
Warrant^F1,F3	$1.25	Jun 12, 2015	J	1	A	Jun 12, 2015	Jun 12, 2020	Common Stock	—	1	I

F1Security held by Alfred D'Agostino Revocable Living Trust.
F2Pursuant to the terms of the Convertible Debenture (the "Debenture"), the Debenture was automatically converted upon a Qualified Offering. Upon conversion of the Debenture Mr. D.Agostino received 1 unit comprised of (i) five hundred (500) shares of Series A Preferred ("Unit Shares"), convertible into the Company's Common Stock at a conversion price of $1.25 per share and (ii) one (1) Warrant to purchase 100% of the number of Conversion Shares (as defined in the Debenture) initially issuable upon conversion of the Unit Shares to the purchaser at the exercise price of $1.25 per share.
F3The Warrant entitles Mr. D'Agostino to purchase up to the number of shares of Common Stock ("Warrant Shares") that is equal to 100% of the number of Conversion Shares initially issuable upon conversion of the Unit Shares issued to the purchaser. The Warrants are for a term of five (5) years and are exercisable at a price of $1.25 per Warrant Share.
F4The Series A Convertible Preferred Stock has no expiration date.