SEC Form 4 · accession 0001415889-17-001733
ReposiTrak, Inc. · TRAK
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Randall K Fields
Officer — CHIEF EXECUTIVE OFFICER · Director · 10% Owner
Period of report
Jul 26, 2017
Accepted (ET)
Oct 26, 2017 · 9:19 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000050471
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Series B-1 Preferred StockF1 | Jul 26, 2017 | A | 20,000 | $0.00 | A | 135,788 | I | By Fields Management, Inc. |
| Common StockF2 | holding | — | — | — | 3,698,056 | D | ||
| Common Stock | holding | — | — | — | 650,693 | I | By Riverview Financial Corp. | |
| Common Stock | holding | — | — | — | 30,667 | I | By Spouse | |
| Common StockF3 | holding | — | — | — | 1,289,230 | I | By Fields Management | |
| Series B Preferred Stock | holding | — | — | — | 531,432 | I | By Riverview Financial Corp | |
| Series B Preferred Stock | holding | — | — | — | 14,450 | I | By Spouse | |
| Common Stock | holding | — | — | — | 205,000 | I | By Charitable 2010, LLC | |
| Series B-1 Preferred Stock | holding | — | — | — | 147,370 | I | By Riverview Financial Corp | |
| Series B-1 Preferred Stock | holding | — | — | — | 657 | I | By Spouse |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Warrant | $3.60 | holding | — | — | — | Mar 14, 2013 | Mar 14, 2018 | Common Stock | 6,875 | 6,875 | D |
| Warrant | $10.00 | holding | — | — | — | Jan 26, 2015 | Jan 26, 2020 | Common Stock | 3,165 | 3,165 | D |
| Warrants | $4.00 | holding | — | — | — | Feb 5, 2015 | Feb 5, 2020 | Common Stock | 914,065 | 914,065 | I |
| Warrant | $4.00 | holding | — | — | — | Feb 5, 2015 | Feb 5, 2020 | Common Stock | 40,250 | 40,250 | I |
Explanation of responses
- F1Shares issued as payment of a bonus granted to Fields Management, Inc., a management company wholly-owned by the Reporting Person ("FMI"), by the Compensation Committee of the Issuer's Board of Directors, pursuant to the Employment Agreement by and between the Issuer and FMI, dated June 30, 2013, pursuant to which the Reporting Person serves as the Issuer's Chief Executive Officer.
- F2Includes 5,157 unvested shares of common stock.
- F3Includes 771,587 unvested shares of common stock.