SEC Form 4 · accession 0000921895-19-000593
IMAC Holdings, Inc. · BACK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Jeffrey S Ervin
Officer — Chief Executive Officer · Director
Period of report
Feb 22, 2019
Accepted (ET)
Feb 26, 2019 · 5:24 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0001729944
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common Stock | Feb 22, 2019 | C | 12,835 | $5.00 | A | 261,700 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 4% Convertible NoteF2,F1 | $5.00 | Feb 22, 2019 | C | 12,835 | D | — | Feb 15, 2019 | Common Stock | 12,835 | 0 | D |
Explanation of responses
- F1The Issuer and the Reporting Person agreed to conversion of the $50,000 principal amount and accrued interest upon the closing of the Issuer's initial public offering.
- F2The number of shares underlying the 4% Convertible Note was previouisly disclosed as 12,749; however, due to an increase in accrued interest, the number of underlying shares increased to 12,835 at the time of conversion.