SEC Form 4 · accession 0000899243-19-000251
HICKOK INC · HICKA
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Steven Rosen
Director · 10% Owner
Period of report
Dec 30, 2018
Accepted (ET)
Jan 3, 2019 · 3:21 pm EST
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000047307
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant to Purchase Class A Common StockF1,F3 | $2.50 | Dec 30, 2017 | D | 100,000 | D | — | Dec 30, 2018 | Class A Common Stock | 100,000 | 252,367 | I |
| Warrant to Purchase Class A Common StockF1,F3 | $2.50 | Dec 30, 2018 | A | 100,000 | A | — | Dec 30, 2019 | Class A Common Stock | 100,000 | 426,489 | I |
| Convertible Loan AgreementF2,F3 | $1.85 | Dec 30, 2017 | D | 252,367 | D | — | Dec 30, 2018 | Class A Common Stock | 252,367 | 100,000 | I |
| Convertible Loan AgreementF2,F3,F4 | $1.43 | Dec 30, 2018 | A | 326,489 | A | — | Dec 30, 2019 | Class A Common Stock | 326,489 | 426,489 | I |
| Class A Common Stock Option | $2.925 | holding | — | — | — | Mar 8, 2012 | Mar 8, 2022 | Class A Common Stock | 1,000 | 1,000 | D |
Explanation of responses
- 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.
- F4Does not include the option to purchase up to 75,000 shares of Class B Common Stock of the Issuer in substitution of an equal number of shares of Class A Common Stock since it is subject to shareholder approval.