SEC Form 3
FORM 3 | UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES 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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1. Name and Address of Reporting Person*
(Street)
| 2. Date of Event Requiring Statement (Month/Day/Year) 11/09/2016 | 3. Issuer Name and Ticker or Trading Symbol BOSTON OMAHA Corp [ BOMN ] | |||||||||||||
4. Relationship of Reporting Person(s) to Issuer (Check all applicable)
| 5. 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 Beneficially Owned | |||
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1. Title of Security (Instr. 4) | 2. Amount of Securities Beneficially Owned (Instr. 4) | 3. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 4. Nature of Indirect Beneficial Ownership (Instr. 5) |
Common Stock, par value $0.001 per share | 726,876 | D(1)(2)(3) |
Table II - Derivative Securities Beneficially Owned (e.g., puts, calls, warrants, options, convertible securities) | |||||||
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1. Title of Derivative Security (Instr. 4) | 2. Date Exercisable and Expiration Date (Month/Day/Year) | 3. Title and Amount of Securities Underlying Derivative Security (Instr. 4) | 4. Conversion or Exercise Price of Derivative Security | 5. Ownership Form: Direct (D) or Indirect (I) (Instr. 5) | 6. Nature of Indirect Beneficial Ownership (Instr. 5) | ||
Date Exercisable | Expiration Date | Title | Amount or Number of Shares | ||||
Class A Common Stock Warrants (right to buy) | (4) | 06/18/2025 | Common Stock(4) | 1,262 | 8 | D(1)(2)(3) | |
Class A Common Stock Warrants (right to buy) | (4) | 06/18/2025 | Common Stock(4) | 51,516 | 10 | D(1)(2)(3) | |
Class A Common Stock, par value $0.001 per share | (4) | (4) | Common Stock | 527,780 | (4) | D(1)(2)(3) |
1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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1. Name and Address of Reporting Person*
(Street)
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Explanation of Responses: |
1. All of the reported shares and derivative securities are directly owned by Bouderado Partners, LLC, of which Boulderado Capital, LLC is the managing member and Boulderado Group, LLC is the investment manager. Alexander Rozek ("Mr. Rozek") is the managing member of Boulderado Group, LLC and Boulderado Capital, LLC. Boulderado Capital, LLC, Boulderado Group, LLC and Mr. Rozek could all be deemed to share indirect beneficial ownership of the shares and derivative securities reported herein. |
2. Boulderado Capital, LLC, Boulderado Group, LLC and Mr. Rozek disclaim beneficial ownership except to the extent of their respective pecuniary interests therein, and this report shall not be deemed an admission of beneficial ownership of these securities for Section 16 or for any other purposes. |
3. Mr. Rozek serves as a director of the issuer, and as the co-chief executive officer of the issuer. |
4. The Class A common stock warrants are convertible at any time at the holder's election into shares of the issuer's Class A common stock, which in turn is convertible at any time, at the holder's election and for no additional consideration, into shares of Common Stock on a one-for-one basis. |
Alexander Rozek on behalf of Boulderado Partners, LLC, as managing member of Boulderado Capital, LLC, its managing member | 11/09/2016 | |
Alexander Rozek on behalf of Boulderado Group, LLC, as its managing member | 11/09/2016 | |
Alexander Rozek on behalf of Boulderado Capital, LLC, as its managing member | 11/09/2016 | |
Alexander Rozek | 11/09/2016 | |
** 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 5 (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. |