SEC Form 4 · accession 0001094891-16-000576
Capitol Acquisition Corp. III · CLAC
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Richard C Donaldson
Director
Period of report
Aug 12, 2016
Accepted (ET)
Aug 16, 2016 · 9:46 am EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001648955
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Convertible Promissory NoteF3,F1,F2 | $1.00 | Aug 12, 2016 | A | 12,121 | A | — | — | Warrants (right to buy) | 12,121 | 12,121 | D |
Explanation of responses
- F1The promissory note is convertible, at the Reporting Person's option, at the closing of the Issuer's initial business combination.
- F2Each warrant entitles the Reporting Person to purchase one share of common stock at a price of $11.50 per share. The warrants become exercisable 30 days after the completion of an initial business combination or 12 months from the closing of the Issuer's initial public offering.
- F3The convertible promissory note was issued in consideration of a loan made by the Reporting Person in the same amount.