|4Mar 21, 6:04 AM ET

INTELLINETICS, INC. 4

4 · INTELLINETICS, INC. · Filed Mar 21, 2016

Insider Transaction Report

Form 4
Period: 2015-12-31
Chretien Matthew L
EVP, CTO and CFO10% Owner
Transactions
  • Conversion

    Convertible Note

    2015-12-31$12715.00/sh500,000 total
    Common stock (22,705 underlying)
  • Conversion

    Common Stock

    2015-12-31$12715.00/sh+22,705$288,694,075919,033 total
  • Award

    Option

    2016-01-01+100,000610,595 total
    Exercise: $0.90Exp: 2025-12-31Common stock (100,000 underlying)
  • Award

    Common Stock

    2016-01-02+8,333927,366 total
  • Conversion

    Warrant

    2015-12-31+10,595510,595 total
    Exercise: $0.65From: 2015-12-31Exp: 2020-12-30Common stock (10,595 underlying)
Footnotes (4)
  • [F1]Granted in exchange for director or officer services to the Company, in accordance with the 2015 Intellinetics Inc. Equity Incentive Plan.
  • [F2]Convertible notes were converted into equity and warrants as part of a note exchange offering. Each outstanding convertible note was converted into common stock at its conversion price, and each noteholder exercising notes also received warrants to purchase common stock in an amount equal to 50% of the total principal and interested converted, divided by 0.6.
  • [F3]N/A
  • [F4]25% of the options vest annually, beginning on January 1, 2016.

Documents

1 file
  • 4
    v434818_4.xmlPrimary

    OWNERSHIP DOCUMENT