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 chatAND, Inc. [ CHAA ] | 5. Relationship of Reporting Person(s) to Issuer (Check all applicable)
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3. Date of Earliest Transaction (Month/Day/Year) 07/05/2016 | ||||||||||||||||||||||||||
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 | ||||||
Common Stock, par value $0.00001 | 6,208,308(1) | D |
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 | ||||||||
10% Convertible Promissory Note | $0.01 | 07/05/2016 | P | $15,000 | (2) | (2) | Common Stock | 1,500,000 | $15,000 | 1,500,000 | D | ||||
Warrant to Purchase Shares of Common Stock | $0.02 | 07/05/2016 | P | $0.00(3) | (3) | 07/05/2021 | Common Stock | 750,000 | $0.00(3) | 750,000 | D |
Explanation of Responses: |
1. Represents the following number of shares owned by the Reporting Person: (i) 6,020,099 shares issued on April 30, 2014 pursuant to an exchange of an identical number of shares previously issued to the Reporting Person pursuant to the terms of the Senior Secured Convertible Promissory Note and Warrant to Purchase Shares of Common Stock as set forth as Exhibits 10.4 and 10.5, respectively, to the Issuer's Registration Statement on Form S-1 filed with the Securities and Exchange Commission on September 2, 2011 and issued to the Reporting Person by the Issuer in June 2011 and; (ii) 153,409 shares issued to the Reporting Person on June 17, 2011; and (iii) 34,800 shares held by the Reporting Person in his brokerage account. |
2. On July 5, 2016, the Reporting Person invested $15,000 in the Issuer pursuant to the terms of a 10% Convertible Promissory Note (the "Note"). The Note is convertible at $0.01 per share and is convertible at any time after issuance until all principal and/or accrued interest has either by repaid or converted. The Note is due on July 5, 2017. In the event the Company raises additional capital at a price per share below $0.01, the conversion price of the Note shall be reduced to such an amount. |
3. In connection with the Note, the Issuer issued to the Reporting Person a Warrant to Purchase Shares of Common Stock for 750,000 shares of the Issuer's common stock (the "Warrant"). The Warrant is exercisable from the date of issuance for a period of five years. The exercise price of the Warrant is $0.02 per share and the Warrant contains a cashless exercise option at the discretion of the Reporting Person. In the event the Company raises additional capital at a price per share below $0.02, the conversion price of the Warrant shall be reduced to such an amount; provided, however, the $0.01 conversion price of the Note shall not trigger this provision. |
/s/ David Stefansky | 07/07/2016 | |
** 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. |