SEC Form 4/A · accession 0001654954-17-003194
NOBLE ROMANS INC · NROM
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
This is an amendment (Form 4/A). It replaces an earlier filing for the same period.
Reporting owner
Paul W Mobley
Officer — Executive Chairman · Director · 10% Owner
Period of report
Nov 8, 2016
Accepted (ET)
Apr 10, 2017 · 5:51 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000709005
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, Subordinated, Unsecured Promissory NoteF1 | $0.50 | Nov 8, 2016 | A | 100,000 | A | Nov 8, 2016 | Nov 8, 2019 | Noble Roman's Inc | 300,000 | 1,573,333 | D |
| Convertible, Subordinated, Unsecured Promissory NoteF1 | $0.50 | Dec 16, 2016 | A | 50,000 | A | Dec 29, 2016 | Dec 29, 2019 | Noble Roman's Inc | 150,000 | 1,723,777 | D |
Explanation of responses
- F1Interest on the notes accrues at the annual rate of 10% payable quarterly in arrears. Principal of the notes matures three years after issuance. Each holder of the notes may convert them at any time during the term of the notes into common stock of the company at a conversion rate of $.50 per share. Also with the notes are warrants which may be redeemed for common stock of the company at the exercise price of $1.00 per share. The warrants expire at the end of three years.