SEC Form 4 · accession 0001615774-16-007257
Beeline Holdings, Inc. · BLNE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Lawrence Hirson
Director · 10% Owner
Period of report
Sep 15, 2016
Accepted (ET)
Sep 19, 2016 · 5:04 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 | Sep 15, 2016 | P | 500,000 | $0.03 | A | 10,500,000 | I | By LLC |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF1 | $0.10 | Sep 19, 2016 | A | 1,500,000 | A | Sep 19, 2016 | Sep 19, 2019 | Common Stock | 1,500,000 | 11,500,000 | I |
| WarrantsF1 | $0.10 | holding | — | — | — | Jun 9, 2016 | Jun 9, 2019 | Common Stock | 10,000,000 | 10,000,000 | I |
Explanation of responses
- F1The reporting person is the manager of WATB ISA, LLC, which is the owner of the reported securities. The reporting person disclaims beneficial ownership of the securities owned by WATB ISA, LLC, 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.