SEC Form 4 · accession 0001249155-18-000048
Beeline Holdings, Inc. · BLNE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jack N Peterson
Director
Period of report
Aug 11, 2018
Accepted (ET)
Aug 24, 2018 · 6:06 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 StockF1,F2 | Aug 11, 2018 | X | 42,000 | $3.50 | A | 83,359 | I | By Sandstrom Partners, Inc. |
| Common Stock | holding | — | — | — | 9,400 | D |
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)F2 | $3.50 | Aug 11, 2018 | X | 42,000 | D | Aug 11, 2017 | Aug 11, 2018 | Common Stock | 42,000 | 0 | I |
Explanation of responses
- F1The consideration for the exercise of the warrants was services rendered to the Issuer.
- F2The reporting person is the President, a director and a principal shareholder of Sandstrom Partners, Inc. He disclaims beneficial ownership of these securities except to the extent of his pecuniary interest therein. The inclusion of these shares in this report shall not be deemed an admission of beneficial ownership of all of the reported shares for purposes of Section 16 or for any other purpose.