Rosen Arthur 5

5 · Creatd, Inc. · Filed Feb 16, 2021

Form 5

Period: 2020-12-31

10% Owner

Transactions

Conversion
Common Stock, $0.001 par value per share
2020-09-15$2.93/sh+85,318$249,982→ 817,980 total
Conversion
Common Stock, $0.001 par value per share
2020-09-15$2.93/sh+350,427$1,026,751→ 732,662 total
Other
Warrants to Purchase Common Stock
2020-09-15$4.50/sh+12,798$57,591→ 12,798 total
Exercise: $4.50From: 2020-09-15Exp: 2025-09-15→ Common Stock (12,798 underlying)
Purchase
Common Stock, $0.001 par value per share
2020-12-31$11.00/sh+7,864$86,504→ 825,844 total
Other
Warrants to Purchase Common Stock
2020-09-15$4.50/sh+52,564$236,538→ 52,564 total
Exercise: $4.50From: 2020-09-15Exp: 2025-09-15→ Common Stock (52,564 underlying)

Footnotes (6)

[F1]On September 15, 2020, Reporting Person converted $1,026,751 in principal (the "Principal") under a 12.5% Convertible Note (the "Convertible Note") into 350,427 shares of common stock at $2.93 per share.
[F2]On September 15, 2020, Reporting Person converted $249,982 in interest (the "Interest") under the Convertible Note into 85,318 shares of common stock at $2.93 per share.
[F3]Reporting Person made an open market purchase of common stock.
[F4]On September 15, 2020, Reporting Person was issued a common stock purchase warrant to acquire 52,564 shares of common stock at $4.50 per share in consideration of converting the Principal under the Convertible Note.
[F5]On September 15, 2020, Reporting Person was issued a common stock purchase warrant to acquire 12,798 shares of common stock at $4.50 per share in consideration of converting the Interest under the Convertible Note.
[F6]On August 17, 2020, the Issuer effected a 1:3 reverse stock split of its issued and outstanding shares of common stock.

Documents

1 file