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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, Section 17(a) of the Public Utility Holding Company Act of 1935 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 | ||||||||
Convertible, subordinated, unsecured promissory notes (2) | $ 0.5 | 11/08/2016 | 11/08/2016 | A | $ 200,000 | 11/08/2016 | 11/08/2019 | Noble Romans Inc. | 600,000 (2) | $ 0.5 (2) | 635,000 | I | Convertible is purchased by Herbst Capital Mgt., LLC (1) |
Reporting Owner Name / Address | Relationships | |||
Director | 10% Owner | Officer | Other | |
Herbst Marcel 2846 N. SOUTHPORT AVE UNIT 3N CHICAGO, X1 60657 |
X |
Marcel Herbst | 11/09/2016 | |
**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 Convertible and attached warrants are held in the account of Herbst Capital Management, LLC. (the "fund") for which Herbst Capital Partners, LLC (the "General Partner") serves as its manager. Marcel Herbst is the General Manager of Herbst Capital Partners, LLC and also serves as the Portfolio Manager of Herbst Capital Management, LLC. Mr. Herbst may be deemed to beneficially own these securities held by the fund by virtue of the General Partner's position in the fund and Mr. Herbst's status as the general manager of the General Partner and his status as portfolio manager of the fund. |
(2) | Interest on the Notes accrues at the annual rate of 10% and is payable quarterly in arrears. Principal of the Notes matures three years after issuance. Each holder of the Notes may convert them at any time into Common Stock of the Company at a conversion price of $0.50 per share. The Warrants expire three years from the date of issuance and provide for an exercise price of $1.00 per share of Common Stock |