Home/Filings/4/0001140361-12-044386
4//SEC Filing

Adams J. Kevin 4

Accession 0001140361-12-044386

CIK 0001526543other

Filed

Oct 21, 8:00 PM ET

Accepted

Oct 22, 5:24 PM ET

Size

5.3 KB

Accession

0001140361-12-044386

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

Issuer

Green Ballast, Inc.

CIK 0001526543

Entity typeother

Related Parties

1
  • filerCIK 0001490966

Filing Metadata

Form type
4
Filed
Oct 21, 8:00 PM ET
Accepted
Oct 22, 5:24 PM ET
Size
5.3 KB