SEC Form 5 · accession 0001640334-17-001747
Mirage Energy Corp · MRGE
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Michael R Ward
Officer — CEO · Director · 10% Owner
Period of report
Jul 31, 2017
Accepted (ET)
Aug 18, 2017 · 5:16 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001623360
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1,F2 | Aug 11, 2016 | P | 117,864,000 | $150,604.00 | D | 127,864,000 | D | |
| Common StockF3,F5 | Jan 24, 2017 | P$0 | 10,000,000 | $0.00 | D | 10,000,000 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Preferred Stock Series AF4,F5,F6,F7 | $0.00 | Jan 24, 2017 | P | 10,000,000 | A | Jan 24, 2017 | — | Common | 200,000,000 | 10,000,000 | D |
Explanation of responses
- F1Previously reported Form 3 on 8/16/16 as 3,274,000 pre-forward split shares.
- F2The 127,864,000 includes the 10,000,000 shares from Line 2.
- F3Shares acquired in a business combination transaction as disclosed on Form 8-K filed 1/27/17.
- F4The Series A shares were acquired in a business combination transaction described in Current Report Form 8-K filed January 27, 2017. The Series A Preferred Stock was designated in an amendment to the Company's articles of Incorporation filed in Current Report on Form 8-K on November 10, 2016.
- F5No monetary value established in a share exchange business combination transaction.
- F6Series A
- F7N/A