SEC Form 4/A · accession 0001019056-16-001718
Synergy CHC Corp. · SNYR
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
Knight Therapeutics (Barbados) Inc.
10% Owner
Period of report
Dec 22, 2016
Accepted (ET)
Dec 23, 2016 · 12:51 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001562733
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Dec 22, 2016 | J | 7,500,000 | — | A | 17,645,812 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantsF1 | $0.34 | Dec 22, 2016 | J | 1 | A | Jan 22, 2015 | Jan 22, 2025 | Common Shares | 3,584,759 | 0 | D |
| WarrantsF1 | $0.49 | Dec 22, 2016 | J | 1 | A | Nov 12, 2015 | Nov 12, 2025 | Common Shares | 4,547,243 | 0 | D |
| Stock OptionsF1 | $0.25 | Dec 22, 2016 | J | 1 | A | Dec 14, 2015 | Dec 14, 2025 | Common Shares | 1,000,000 | 0 | D |
Explanation of responses
- F1The Reporting Person received 7,500,000 common shares in the capital of the Issuer as consideration for the cancellation of the following derivative securities: (i) a share purchase warrant dated January 22, 2015 exercisable into 3,584,759 common shares of the Issuer, (ii) a share purchase warrant dated November 12, 2015 exercisable into 4,547,243 common shares of the Issuer, and (iii) stock options with respect to 1,000,000 common shares of the Issuer.