SEC Form 4 · accession 0001144204-15-055445
DSS, INC. · DSS
Statement of changes in beneficial ownership, as filed. Original on EDGAR ↗
Reporting owner
Robert B Fagenson
Director
Period of report
Sep 15, 2015
Accepted (ET)
Sep 17, 2015 · 4:01 pm EDT
Rule 10b5-1 plan
unknown — predates the checkbox
Issuer CIK
0000771999
Table I — non-derivative securities
| Security | Date | Code | Shares | Price | A/D | Owned after | D/I | Nature of ownership |
|---|---|---|---|---|---|---|---|---|
| Common StockF1 | Sep 15, 2015 | P | 454,545 | $0.22 | A | 1,335,321 | D |
Table II — derivative securities
| Security | Conv. / exercise price | Date | Code | Shares | A/D | Exercisable | Expires | Underlying | Underlying shares | Owned after | D/I |
|---|---|---|---|---|---|---|---|---|---|---|---|
| WarrantF2 | $0.40 | Sep 15, 2015 | P | 90,909 | A | Mar 16, 2016 | Mar 16, 2020 | Common Stock | 90,909 | 90,909 | D |
Explanation of responses
- F1Does not include, as previously reported on Form 4, 100,000 shares of the Issuer's common stock ("Common Stock") owned by the Reporting Person's spouse, 50,000 shares of Common Stock owned by a trust for the benefit of Stephanie Fagenson, and 50,000 shares of Common Stock owned by a trust for the benefit of Jennifer Fagenson.
- F2Warrant issued at no additional cost in connection with the Reporting Person's purchase of 454,545 shares of Common Stock from the Issuer.