SEC Form 4
FORM 4 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Check this box if no longer subject to Section 16. Form 4 or Form 5 obligations may continue. See Instruction 1(b). |
1. Name and Address of Reporting Person*
(Street)
| 2. Issuer Name and Ticker or Trading Symbol SPENDSMART NETWORKS, INC. [ SSPC ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 11/13/2015 | ||||||||||||||||||||||||||
4. If Amendment, Date of Original Filed (Month/Day/Year) | 6. Individual or Joint/Group Filing (Check Applicable Line)
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Table I - Non-Derivative Securities Acquired, Disposed of, or Beneficially Owned | ||||||||||
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1. Title of Security (Instr. 3) | 2. Transaction Date (Month/Day/Year) | 2A. Deemed Execution Date, if any (Month/Day/Year) | 3. Transaction Code (Instr. 8) | 4. Securities Acquired (A) or Disposed Of (D) (Instr. 3, 4 and 5) | 5. Amount of Securities Beneficially Owned Following Reported Transaction(s) (Instr. 3 and 4) | 6. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 7. Nature of Indirect Beneficial Ownership (Instr. 4) | |||
Code | V | Amount | (A) or (D) | Price |
Table II - Derivative Securities Acquired, Disposed of, or Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||||||||||
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1. Title of Derivative Security (Instr. 3) | 2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) | 5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4 and 5) | 6. Date Exercisable and Expiration Date (Month/Day/Year) | 7. Title and Amount of Securities Underlying Derivative Security (Instr. 3 and 4) | 8. Price of Derivative Security (Instr. 5) | 9. Number of derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) | 10. Ownership Form: Direct (D) or Indirect (I) (Instr. 4) | 11. Nature of Indirect Beneficial Ownership (Instr. 4) | ||||
Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||||||
Convertible Promissary Note (right to buy) | $0.75 | 11/13/2015 | A | 45,333(1) | 11/13/2015 | 05/13/2016 | Common Stock | 45,333(3) | $34,000 | 45,333(1) | D | ||||
Convertible Promissary Note (right to buy) | $0.75 | 11/13/2015 | A | 231,111(2) | 11/13/2015 | 05/13/2016 | Common Stock | 231,111(3) | $173,333.28 | 231,111(2) | I | By Trust | |||
Warrant (right to buy) | $6 | 11/13/2015 | D(4) | 125,000 | (4) | 11/16/2015 | Common Stock | 125,000 | (4) | 0 | D | ||||
Warrant (right to buy) | $6 | 11/13/2015 | A(4) | 125,000 | (4) | 12/16/2015 | Common Stock | 125,000 | (4) | 125,000 | D |
Explanation of Responses: |
1. The number of shares represents a Convertible Promissory Note in principal amount of $34,000 and has a maturity date of 5/13/2016 and an annual interest rate of 9%. The outstanding principal and interest may be converted at any time at a conversion rate of $0.75 per share of Common Stock. |
2. The aggregate number of shares represents three Convertible Promissory Notes in principal amounts of $80,000, $53,333.28, and $40,000. Each Note has a maturity date of 5/13/2016 and an annual interest rate of 9%. The outstanding principal and interest may be converted at any time at a conversion rate of $0.75 per share of Common Stock. |
3. This figure represents the number of shares into which the aggregate principal amounts of the Notes may be converted. Additional shares may be issued upon conversion as a result of interest accumulated on the Notes. |
4. The two reported transactions involved an amendment of an outstanding warrant, resulting in a deemed cancellation of the "old" warrant and a grant of a replacement warrant. The warrant was originally granted on November 16, 2010 and was fully exercisable at the time of the transactions. |
Remarks: |
/s/ Ori Solomon - Attorney-in-Fact for Isaac Blech | 11/17/2015 | |
** Signature of Reporting Person | Date | |
Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | ||
* If the form is filed by more than one reporting person, see Instruction 4 (b)(v). | ||
** Intentional misstatements or omissions of facts constitute Federal Criminal Violations See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). | ||
Note: File three copies of this Form, one of which must be manually signed. If space is insufficient, see Instruction 6 for procedure. | ||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB Number. |