$INLX·4

INTELLINETICS, INC. · Jan 19, 8:04 PM ET

INTELLINETICS, INC. 4

4 · INTELLINETICS, INC. · Filed Jan 19, 2016

Insider Transaction Report

Form 4
Period: 2015-12-31
Transactions
  • Conversion

    Convertible Note

    2015-12-3168,803640,000 total
    Exercise: $0.56From: 2014-05-30Common stock (113,933 underlying)
  • Award

    COMMON STOCK

    2016-01-02$0.90/sh+36,111$32,500332,543 total
  • Conversion

    COMMON STOCK

    2015-12-31$0.56/sh+113,993$63,836296,432 total
  • Conversion

    Warrant

    2015-12-31+53,169693,169 total
    Exercise: $0.65From: 2015-12-30Exp: 2020-12-30Common stock (53,169 underlying)
Footnotes (3)
  • [F1]Grant of stock under the 2015 Intellinetics, Inc. Equity Incentive Plan for director services rendered.
  • [F2]Convertible Note was converted into both common stock and warrants pursuant to a private offering conducted by the Company. Notes were converted to common stock attheir stated conversion price, and warrants were granted in an amount equal to 50% of the total principal and interest converted, multiplied by 0.6.
  • [F3]N/A.

Documents

1 file
  • 4
    v429209_form4.xmlPrimary

    FORM 4