|4Oct 22, 5:24 PM ET

Adams J. Kevin 4

4 · Green Ballast, Inc. · Filed Oct 22, 2012

Insider Transaction Report

Form 4
Period: 2012-10-16
Adams J. Kevin
DirectorPresident and CEO10% Owner
Transactions
  • Other

    Common Stock

    2012-10-16334,00024,609,450 total(indirect: By Partnership)
Footnotes (1)
  • [F1]On October 16, 2012, the Adams Family Limited Partnership (the "Family LP"), the reporting person and the issuer entered into a Stock Surrender Agreement dated October 16, 2012 pursuant to which the Family LP surrendered 334,000 shares of common stock to the issuer. The Stock Surrender Agreement and the surrendering of shares by the Family LP were a condition to the initial closing of the issuer's private offering of notes and common stock on October 16, 2012.

Documents

1 file
  • 4
    doc1.xmlPrimary

    FORM 4