Filing Details

Accession Number:
0001179110-16-032830
Form Type:
4
Zero Holdings:
No
Publication Time:
2016-12-12 17:03:35
Reporting Period:
2016-05-03
Filing Date:
2016-12-12
Accepted Time:
2016-12-12 17:03:35
SEC Url:
Form 4 Filing
Issuer
Cik Name Symbol Sector (SIC) IRS No
1356093 Creative Realities Inc. CREX () 4
Insiders
Cik Name Reported Address Insider Title Director Officer Large Shareholder Other
1215270 J Eric Bertrand Lincoln Road Media Partners Llc
444 Brickell Ave Suite 900
Miami FL 33131
Yes No No No
Reported Non-Derivative Transactions
Sec. Name Acquisiton - Disposition Date Amount Price Remaning Holdings Equity Swap Involved Form Type Code Nature of Ownership Explanation
Common Stock Acquisiton 2016-09-08 19,000 $0.15 19,000 No 4 P Direct
Equity Swap Involved Form Type Code Nature of Ownership Explanation
No 4 P Direct
Reported Derivative Transactions
Sec. Name Sec. Type Acquisiton - Disposition Date Amount Price Amount - 2 Price - 2
Common Stock Secured Convertible Promissory Note Acquisiton 2016-05-03 2,110,371 $500,000.00 2,110,371 $0.00
Common Stock Warrants to purchase common stock Acquisiton 2016-05-03 892,857 $0.00 892,857 $0.28
Remaning Holdings Exercise Date Expiration Date Equity Swap Involved Transaction Form Type Transaction Code Nature of Ownership
2,110,371 2016-05-03 2017-10-15 No 4 P Indirect
892,857 2016-05-03 2021-05-03 No 4 P Indirect
Footnotes
  1. Purchase involved a Secured Convertible Promissory Note for $500,000, which is convertible into approximately 2,110,371 shares of Common Stock; and a Warrant to purchase 892,857 shares of Common Stock. The Warrant contains provisions blocking exercise if such exercise would result in the purchaser holding more than 4.99% of the Issuer's shares outstanding.
  2. The Reporting Person is a principal of Lincoln Road Media Partners LLC and has voting and investment power for this entity.