SEC Form 5 · accession 0001209191-16-098917
Notis Global, Inc. · NGBL
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Ned L Siegel
Director
Period of report
Dec 31, 2015
Accepted (ET)
Feb 16, 2016 · 5:58 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001547996
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Mar 31, 2015 | M | 56,250 | $0.00 | A | 3,283,261 | D | |
| Common StockF3 | Jul 1, 2015 | A | 18,750 | $0.00 | A | 3,302,011 | D | |
| Common StockF4,F5 | Jul 1, 2015 | A | 6,250 | $0.00 | A | 3,308,261 | D | |
| Common StockF3 | Oct 1, 2015 | A | 18,750 | $0.00 | A | 3,327,011 | D | |
| Common StockF4,F5 | Oct 1, 2015 | A | 6,250 | $0.00 | A | 3,333,261 | D | |
| Common StockF6 | Dec 31, 2015 | A | 1,429,500 | $0.00 | A | 4,762,761 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Restricted Stock UnitsF7,F8 | $0.00 | Mar 31, 2015 | M | 56,250 | D | — | — | Common Stock | 56,250 | 0 | D |
| WarrantF9 | $0.40 | Jul 10, 2015 | J | 129,305 | A | Jul 10, 2015 | Jan 30, 2018 | Common Stock | 129,305 | 129,305 | D |
| WarrantF9 | $0.40 | Jul 10, 2015 | J | 129,917 | A | Jul 10, 2015 | Jan 5, 2018 | Common Stock | 129,917 | 129,917 | D |
Explanation of responses
- F1Common stock of Issuer acquired by Reporting Person upon conversion of restricted stock units ("RSUs") in accordance with the award agreement.
- F2RSUs granted August 21, 2014 were fully vested and converted to common stock of Issuer on transaction date.
- F3Common stock awarded to Reporting Person pursuant to Issuer's 2014 Equity Incentive Plan, as amended. Such award is part of an inducement grant to Reporting Person for services as a director of Issuer.
- F4RSUs awarded to Reporting Person pursuant to Issuer's 2014 Equity Incentive Plan, as amended, which vested on the transaction date. Each vested RSU is payable in one share of common stock. Such award is part of an inducement grant to Reporting Person for services as a director of Issuer.
- F5The number of shares of Issuer's common stock represented by RSUs granted under Issuer's 2014 Equity Incentive Plan as part of Reporting Person's compensation as a director of Issuer. See also footnote number 4.
- F6Award of Issuer's common stock under Issuer's 2014 Equity Incentive Plan. Such award was made as bonus compensation for Reporting Person's services as a director of Issuer for the period August 1, 2015 through December 31, 2015.
- F7RSUs may be converted into common stock of Issuer upon vesting, at holder's election.
- F8Not applicable.
- F9Warrant acquired by Reporting Person pursuant to the terms of and in conjunction with Reporting Person's conversion of a convertible debenture of Issuer on July 10, 2015.