SEC Form 4 · accession 0000899243-16-010568

HICKOK INC · HICKA

Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗

Reporting owner

Director · 10% Owner

Period of report

Dec 30, 2015

Accepted (ET)

Jan 4, 2016 · 11:13 am EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000047307

Table I — non-derivative securities

No Table I lines on this filing.

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant to Purchase Class A Common Stock^F1,F3	$2.50	Dec 30, 2015	D	100,000	D	—	Dec 30, 2015	Class A Common Stock	100,000	252,367	I
Warrant to Purchase Class A Common Stock^F1,F3	$2.50	Dec 30, 2015	A	100,000	A	—	Dec 30, 2016	Class A Common Stock	100,000	352,367	I
Convertible Loan Agreement^F2,F3	$1.85	Dec 30, 2015	D	252,367	D	—	Dec 30, 2015	Class B Common Stock	252,367	100,000	I
Convertible Loan Agreement^F2,F3	$1.85	Dec 30, 2015	A	252,367	A	—	Dec 30, 2016	Class B Common Stock	252,367	352,367	I

F1The two reported transactions involved an amendment of an outstanding warrant, resulting in the deemed cancellation of the "old" warrant and the grant of a replacement warrant.
F2The two reported transactions involved an amendment of an outstanding convertible loan agreement, resulting in the deemed cancellation of the "old" convertible loan agreement and the entry into a replacement convertible loan agreement.
F3The securities reported herein are owned directly by Roundball, LLC, an Ohio limited liability company. For purposes of the Securities Exchange Act of 1934, the Reporting Person disclaims beneficial ownership of any securities, except of his pecuniary interest therein, if any, and this report shall not be deemed an admission that the Reporting Person is the beneficial owner of such securities for purposes of Section 16 or otherwise.