SEC Form 4 · accession 0001249155-17-000042

Beeline Holdings, Inc. · BLNE

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

Reporting owner

Grover T. Wickersham

Officer — Chairman and CEO · Director

Period of report

Jun 2, 2017

Accepted (ET)

Jun 6, 2017 · 6:19 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001534708

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Common Stock^F1	Jun 2, 2017	P	45,565	$1.30	A	224,670	D
Common Stock^F2	holding	—	—		—	127,320	I	By Charitable Remainder Trust
Common Stock^F3	holding	—	—		—	447,924	I	By Employee Profit Sharing Plan
Common Stock^F4	holding	—	—		—	220,900	I	By Irrevocable Trust

Table II — derivative securities

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Common Stock Purchase Warrants (right to buy)^F1	$2.50	Jun 2, 2017	P	45,565	A	Jun 2, 2017	Jun 2, 2020	Common Stock	45,565	45,565	D

Explanation of responses

F1The shares reported on Table I and the warrants reported on Table II of this Form 4 were purchased in units, each unit consisting of one share of common stock and one warrant, at a purchase price of $1.30 per unit. The Issuer did not allocate the purchase price between the component securities.
F2The reporting person is a joint trustee and beneficiary of the Grover T. and Jill Z. Wickersham 2000 Charitable Remainder Trust (the "CRUT"), which is the owner of the reported securities. The reporting person disclaims beneficial ownership of the securities owned by the CRUT, except to the extent of his pecuniary interest therein. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the securities for purposes of Section 16 or for any other purposes.
F3The reporting person is the trustee of the Grover T. Wickersham, P.C. Employees' Profit Sharing Plan (the "PSP"), which is the owner of the reported securities. The reporting person disclaims beneficial ownership of the securities owned by the PSP, except to the extent of his pecuniary interest in the PSP. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.
F4The reporting person is the trustee of the Lindsay Anne Wickersham 1999 Irrevocable Trust (the "Irrevocable Trust"), which is the owner of the reported securities. The reporting person disclaims beneficial ownership of the securities owned by the Irrevocable Trust. The inclusion of these securities in this report shall not be deemed an admission of beneficial ownership of the reported securities for purposes of Section 16 or for any other purposes.