Jerrick Media Holdings, Inc. 5

5 · Jerrick Media Holdings, Inc. · Filed Feb 3, 2017

Form 5

Period: 2016-12-31

Director

Transactions

Other
Series A Preferred Stock
2016-02-05+1,113→ 1,113 total
Exercise: $0.16From: 2016-02-05Exp: 2020-11-17→ Common Stock (678,658 underlying)
Award
Options to Purchase Common Stock
2016-07-01+300,000→ 300,000 total
Exercise: $0.25From: 2016-07-01Exp: 2021-06-30→ Common Stock (300,000 underlying)
Purchase
Warrants to Purchase Common Stock
2016-02-05+100,000→ 100,000 total
Exercise: $0.23From: 2016-02-05Exp: 2019-12-09→ Common Stock (100,000 underlying)
Other
Warrants to Purchase Common Stock
2016-02-05+200,000→ 200,000 total
Exercise: $0.23From: 2016-02-05Exp: 2020-11-17→ Common Stock (200,000 underlying)
Award
Warrants to Purchase Common Stock
2016-02-05+40,000→ 40,000 total
Exercise: $0.23From: 2016-02-05Exp: 2020-11-17→ Common Stock (40,000 underlying)

Footnotes (5)

[F1]Derivative Securities issued to Andrew Taffin for serving on the Issuer's Board of Directors.
[F2]On February 5, 2016, Andrew Taffin was appointed as a Director of the Issuer (then, prior to a name change, "Great Plains Holdings, Inc.").
[F3]Issued in consideration for Andrew Taffin's purchase of a Convertible Debenture, dated December 10, 2014 in the principal amount of $100,000 pursuant to the terms of a Bridge Financing.
[F4]Received from the Issuer as consideration for exchange of a Convertible Debenture, dated December 10, 2015 in the principal amount of $100,000.
[F5]Received from the Company as consideration for Andrew Taffin's agreement to amend the terms of a Convertible Debenture, dated December 10, 2014 in the principal amount of $100,000.

Documents

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