SEC Form 4/A · accession 0001615774-16-006243
Beeline Holdings, Inc. · BLNE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Steve Shum
Officer — Chief Financial Officer
Period of report
Apr 4, 2016
Accepted (ET)
Jul 6, 2016 · 7:18 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Series A Preferred StockF1,F2 | $0.075 | Apr 4, 2016 | A | 97 | A | Apr 4, 2016 | — | Common Stock | 1,293,334 | 1,293,334 | D |
| WarrantsF1 | $0.10 | Apr 4, 2016 | A | 1,293,204 | A | Apr 4, 2016 | Apr 4, 2019 | Common Stock | 1,293,204 | 1,293,204 | D |
| Stock Option | $0.45 | holding | — | — | — | Oct 1, 2015 | Oct 1, 2020 | Common Stock | 850,000 | 850,000 | D |
Explanation of responses
- F1The Form 4 is being filed to reflect the amended terms of the securities being reported in the Original Form 4 filing. On June 1, 2016, the certificate of designation for the Series A Preferred Stock was amended to reduce the conversion price thereunder from $0.15 to $0.075 thereby increasing the underlying common stock reported in the Original Form 4 filing. In addition, the warrants reported in the Original Form 4 filing were amended on June 30, 2016 to reduce the exercise price from $0.18 to $0.10 and to increase the shares issuable thereunder.
- F2Not applicable