SEC Form 4 · accession 0001249155-18-000025

Beeline Holdings, Inc. · BLNE

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

Reporting owner

Grover T. Wickersham

Officer — Chairman of the Board & CEO · Director

Period of report

Mar 29, 2018

Accepted (ET)

Apr 3, 2018 · 4:03 pm EDT

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0001534708

Table I — non-derivative securities

No Table I lines on this filing.

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,F2	$5.40	Mar 29, 2018	P	17,930	A	Mar 29, 2018	Aug 10, 2022	Common Stock	17,930	17,930	I
Common Stock Purchase Warrants (right to buy)^F1,F3	$5.40	Mar 29, 2018	P	37,975	A	Mar 29, 2018	Aug 10, 2022	Common Stock	37,975	60,197	I
Common Stock Purchase Warrants (right to buy)	$5.40	holding	—	—	—	Aug 10, 2017	Aug 10, 2022	Common Stock	22,222	22,222	D
Common Stock Purchase Warrants (right to buy)^F4	$5.40	holding	—	—	—	Aug 10, 2017	Aug 10, 2022	Common Stock	11,111	11,111	I

Explanation of responses

F1The warrants were issued in connection with an offering of 5% promissory notes due May 1, 2021. For each $100,000 in principal amount of the note, the investor was issued 10,000 warrants.
F2The reporting person is a joint trustee and beneficiary of the Grover T. and Jill Z. Wickersham 2000 Charitable Remainder Trust (the "CRUT") and directs the disposition thereof. The CRUT 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 reported 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.