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) 10/30/2015 | 3. Issuer Name and Ticker or Trading Symbol PREMIER EXHIBITIONS, INC. [ PRXI ] | |||||||||||||
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, $.0001 par value(1) | 669,643(2)(3) | D |
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 |
Explanation of Responses: |
1. The filing person is a party to a stockholders agreement dated April 2, 2015 among the filing person, each of the other Former Convertible Note Holders (as defined in Footnote 2 below), Mr. Daoping Bao and Ms. Nancy Brenner (as amended, the "Stockholders Agreement"). Under the Stockholders Agreement, one of the other parties to the agreement has the power to vote (and a right of first refusal with respect to) the filing person's and the other parties' equity securities of Premier Exhibitions, Inc. (the "Company"). |
2. In connection with the Merger Agreement entered into as of April 2, 2015, the Company also issued a convertible promissory note (the "Convertible Note") to Mr. Daoping Bao, as agent for the filing person and certain other lenders party to the Stockholders Agreement (collectively, the "Former Convertible Note Holders"). On October 30, 2015, the Convertible Note automatically converted into an aggregate total of 3,013,393 shares of the Company's common stock, of which only the shares issued to the filing person are listed in Table I above. On October 30, 2015, the number of shares beneficially owned, directly or indirectly, by the filing person and the other parties to the Stockholders Agreement, pursuant to the definition of beneficial ownership set forth in Securities Exchange Act Rules 13d-3 and 16a-1(a)(1), exceeded 10 percent of the total shares outstanding of the class. |
3. The filing person disclaims beneficial ownership of the shares beneficially owned by the other parties to the Stockholders Agreement except to the extent of his, her or its pecuniary interest therein. |
Remarks: |
Exhibit 24 - Joint Filing Agreement and Power of Attorney |
/s/ Danielle Moore Burton, Attorney-in-fact | 11/12/2015 | |
** 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 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. |