ITEM 5. Jurisdictions in Which Securities Are to Be Offered
Using the list below, select the jurisdictions in which the issuer intends to offer the securities:
All States, Provinces, Territories or Possessions of the United States and Canada, and the District of Columbia.
Using the list below, select the jurisdictions in which the securities are to be offered by underwriters, dealers or sales persons or check the appropriate box:
☒
None
☐
Same as the jurisdictions in which the issuer intends to offer the securities.
No Underwriters are intended to be employed with respect to this offering.
ITEM 6. Unregistered Securities Issued or Sold Within One Year
☐
None
As to any unregistered securities issued by the issuer or any of its predecessors or affiliated issuers within one year before the filing of this Form 1-A, state:
(a)
Name of such issuer.
(b)
| (1)
| Title of securities issued |
(2)
Total amount of such securities issued
(3)
Amount of such securities sold by or for the account of any person who at the time was a director, officer, promoter or principal security holder of the issuer of such securities, or was an underwriter of any securities of such issuer
(c)
| (1)
| Aggregate consideration for which the securities were issued and basis for computing the amount thereof. |
StreetShares, Inc. (as of October 31, 2015):
Common Stock: 10,253,914 total shares issued, 401,929 (vested) shares sold to officers, directors, and principal security holders of the Issuer, approximately $20,096 (vested) Total Consideration (Total Shares x Price per Share less fees and expenses).
Options to Acquire Common Stock: 527,866 aggregate shares underlying options granted, 142,567 shares underlying options granted to officers, directors, and principal security holders of the Issuer, $0 Total Consideration Received.
Warrants to Acquire Common Stock: 367,023 total shares, 0 shares issued to officers, directors, and principal security holders of the Issuer, $0 Total Consideration.
Series Seed Preferred Stock: 4,735,924 shares issued, 3,859,580 shares sold to officers, directors, and principal security holders of the Issuer, $1,019,999 Total consideration (Total Shares Price, per share less fees and expenses).
Convertible Promissory Notes: $2,449,500 aggregate principal amount issued, $450,000 of which was sold to officers, directors, and principal security holders of the Issuer, approximately $2,400,000 Total Consideration (Total proceeds less fees and expenses).
Member Payment Dependent Notes: $1,740,737 aggregate principal amount issued, $0 aggregate principal amount of notes sold to officers, directors, and principal security holders of the Issuer, approximately $1,740,737 Total Consideration (Aggregate Principal Amount of Notes Issued less fees and expenses).
No Underwriters were employed in connection with the offering of the securities described above.
For each of the sales above, no shares were sold by or for the account of any director, officer, promoter, or principal security holder of the issuer.