SEC Form 4 · accession 0001493152-19-001309

PEN INC. · PENC

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

Reporting owner

Officer — President · Director

Period of report

Jan 31, 2019

Accepted (ET)

Feb 4, 2019 · 4:01 pm EST

Rule 10b5-1 plan

unknown — predates the checkbox

Issuer CIK

0000891417

Table I — non-derivative securities

Security	Date	Code	Shares	Price	A/D	Owned after	D/I	Nature of ownership
Class A Common Stock^F1	Jan 31, 2019	P	47,120	$0.40	A	47,120	I	See footnote

Security	Conv. / exercise price	Date	Code	Shares	A/D	Exercisable	Expires	Underlying	Underlying shares	Owned after	D/I
Warrant^F1,F2	$1.50	Jan 31, 2019	P	47,120	A	Jan 31, 2019	—	Class A common stock	47,120	47,120	I
Options^F1	$1.00	Jan 31, 2019	P	29,615	A	Jan 31, 2019	Jun 30, 2019	Class A common stock	29,615	29,615	I
Warrant Options^F1,F3	$0.03	Jan 31, 2019	P	29,615	A	Jan 31, 2019	—	Class A common stock	29,615	29,615	I

F1Shares acquired indirectly and derivative securities acquired indirectly were purchased indirectly through the purchase of an interest in an investing entity that acquired the issuer's securities in a private placement. Reporting person shares voting control over the securities held by the investing entity but reporting person disclaims beneficial ownership of the securities held by the entity for which he does not have pecuniary interest and this filing should not be construed as an admission that the reporting person is the beneficial owner of these securities.
F2Some warrants will expire on the earlier of October 16, 2022 or the date that the Class A common stock has been trading at or above 120% of the exercise price for a period of 90 days, the rest will expire on the earlier of 1/31/2023 or the date that the Class A common stock has been trading at or above 120% of the exercise price for a period of 90 days.
F3Warrant Option can only be purchased after exercise of Option and only for that number of shares purchased as a result of option exercise. If exercised, warrant issued on exercise of Warrant Option will have warrant exercise price of $2.00 per share and will expire on the earlier of October 16, 2022 or date that the Class A common stock has been trading at or above 120% of the exercise price for a period of 90 days.