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UNITED STATES SECURITIES AND EXCHANGE COMMISSION Washington, D.C. 20549STATEMENT OF CHANGES IN BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934 or Section 30(h) of the Investment Company Act of 1940 |
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Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. | |||
Persons who respond to the collection of information contained in this form are not required to respond unless the form displays a currently valid OMB control number. | SEC 1474 (9-02) |
1. Title of Derivative Security (Instr. 3) |
2. Conversion or Exercise Price of Derivative Security | 3. Transaction Date (Month/Day/Year) | 3A. Deemed Execution Date, if any (Month/Day/Year) | 4. Transaction Code (Instr. 8) |
5. Number of Derivative Securities Acquired (A) or Disposed of (D) (Instr. 3, 4, and 5) |
6. Date Exercisable and Expiration Date (Month/Day/Year) |
7. Title and Amount of Underlying Securities (Instr. 3 and 4) |
8. Price of Derivative Security (Instr. 5) |
9. Number of Derivative Securities Beneficially Owned Following Reported Transaction(s) (Instr. 4) |
10. Ownership Form of Derivative Security: Direct (D) or Indirect (I) (Instr. 4) |
11. Nature of Indirect Beneficial Ownership (Instr. 4) |
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Code | V | (A) | (D) | Date Exercisable | Expiration Date | Title | Amount or Number of Shares |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
KOSKI FAMILY LP 3525 TURTLE CREEK BOULEVARD, UNIT 19-B DALLAS, TX 75219 |
X | |||
KOSKI ROBERT C 7362 HAWKINS ROAD SARASOTA, FL 34241 |
X | X | ||
KOSKI THOMAS L 4995 ASHLEY PARKWAY SARASOTA, FL 34241 |
X | |||
KOSKI CHRISTINE L 3525 TURTLE CREEK BOULDEVARD, UNIT 19-B DALLAS, TX 75219 |
X | |||
KOSKI BEVERLY 3525 TURTLE CREEK BOULDEVARD, UNIT 19-B DALLAS, TX 75219 |
X |
/s/ Mark A. Catchur, as Attorney-in-Fact for CHRISTINE L. KOSKI, BEVERLY KOSKI, KOSKI FAMILY LIMITED PARTNERSHIP, ROBERT C. KOSKI AND THOMAS L. KOSKI | 07/01/2016 | |
**Signature of Reporting Person | Date |
* | If the form is filed by more than one reporting person, see Instruction 4(b)(v). |
** | Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). |
(1) | The shares were acquired pursuant to a private placement conducted by the Company. |
(2) | Shares owned directly by Koski Family Limited Partnership ("KFLP"). Shares owned indirectly by the KFLP general partners: Koski Management, Inc. (solely owned by Beverly Koski), Christine L. Koski, Robert C. Koski and Thomas L. Koski, each of whom is a general partner of the partnership or the controlling person of a corporate general partner of the partnership. |
(3) | Each reporting person disclaims beneficial ownership of all indirectly owned securities in excess of such reporting person's pecuniary interest therein, and this report shall not be deemed an admission that the reporting person is the beneficial owner for purposes of Section 16 or any other purpose. |
(4) | Shares owned directly by Christine L. Koski. |
(5) | Shares owned directly by Robert C. Koski, a director of the Company. |
(6) | Shares owned directly by Thomas L. Koski. |
(7) | Shares owned indirectly by Beverly Koski (through Koski Management, Inc.). |
(8) | Shares owned by trusts for Mr. Robert Koski's children of which Mr. Robert C. Koski serves as trustee. Such trusts are as follows: the Robert Clayton Koski Trust for the benefit of Anthony James Hunter (107,600 shares); the Robert Clayton Koski Trust for the benefit of Hunter Buchanan Koski (107,600 shares); the Robert Clayton Koski Trust for the benefit of Clayton Ward Bennett (100,000 shares); the Robert Clayton Koski Trust for the benefit of Robert Edward Koski (107,600 shares); and the Robert Clayton Koski Trust for the benefit of Elyse Margaux Koski (108,051 shares). Mr. Koski disclaims beneficial ownership of the shares held by the trusts except to the extent of any pecuniary interest. |